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Internal Hemorrhoids: First- to Fourth-Degree. A first-degree internal hemorrhoid bulges into the anal canal during bowel movements. A second-degree internal hemorrhoid bulges from the anus during bowel movements, then goes back inside by itself. A third-degreehemorrhoid bulges from the anus during bowel movements and must be pushed back in with a finger. A fourth-degree hemorrhoid protrudes from the anus all the time.
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.