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When a patient has external hemorrhoids, they will lie under the skin around the anus. They can become very itchy and may bleed. Sometimes, the blood may accumulate and form a thrombus (clot), which can be painful; the area will swell and become inflamed. External hemorrhoids are more likely to present with pain.
Sometimes they go away by themselves, but in other cases they can cause lingering pain, itching, and bleeding. There are 2 types of hemorrhoids: those that are just inside the anus or lower rectum (internal) and those that are outside the opening to the anus (external).You can have both at the same time. Internal hemorrhoids usually don't cause pain or discomfort, while external hemorrhoids often do.However, internal hemorrhoids can protrude outside the anus (prolapsed hemorrhoid) and become painful. In some cases, a blot clot (thrombosis) may form in the vein, making the hemorrhoid more painful.nternal hemorrhoids usually don't cause pain or discomfort, while external hemorrhoids often do. However, internal hemorrhoids can protrude outside the anus (prolapsed hemorrhoid) and become painful.