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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.
Updated February 27, 2017. Hemorrhoids, also known as piles, are swollen and distended veins in the anus and lower rectum. About half of all people over age 50 have hemorrhoids. You are more likely to get hemorrhoids if you strain to have bowel movements or sit for prolonged periods of time on the toilet.