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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.
The blood can result from both internal and external hemorrhoids. External hemorrhoids can cause both pain and bleeding. An external hemorrhoid can sometimes get a blood clot lodged within the hemorrhoid which causes thrombosed external hemorrhoid.Medical treatment should be sought 72 hours after development.nternal hemorrhoids are located inside the anal area. They are generally painless since there are no nerve ending present in the inside of the rectum. Internal hemorrhoids can cause variable amounts of bleeding. Bleeding is typically pretty light and does not usually continue for more than 72 hours continuously.