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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.
A Honor Society of Nursing (STTI) answered. If you're having some of the characteristic symptoms of hemorrhoids - swelling, bleeding, or pain - you may want to visit your regular doctor first. Often, hemorrhoids are mild and can be treated with certain lifestyle changes. If your doctor sees indications of a more complicated case of hemorrhoids or a more serious condition, they may refer you to a specialist like a gastroenterologist or a colon and rectal surgeon.