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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.
Hemorrhoids are swollen veins around the anus. They may be inside the anus or outside the anus. Often hemorrhoids do not cause problems. However, if hemorrhoids bleed a lot or cause pain, hemorrhoid surgery can remove them.