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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.
Symptoms of hemorrhoids can often include: 1  Bleeding, usually painless. 2  Itching or irritation in the anal area. 3  Discomfort and pain in the anal region. 4  Lumps protruding from the anal region. 5  Swelling in the anal region. 6  A lump near your anus, this can sometimes be sensitive (painful). 7  Feces may leak (without your wanting it to happen).ymptoms of hemorrhoids can often include: 1  Bleeding, usually painless. 2  The patient may notice red on the toilet paper or in the toilet bowl. 3  Itching or irritation in the anal area. 4  Discomfort and pain in the anal region.