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First degree: the hemorrhoids remain inside at all times. Second degree: the hemorrhoids extend out of the rectum during a bowel movement but return on their own. Third degree: the hemorrhoids extend out during a bowel movement but can be pushed back inside. Fourth degree: the hemorrhoid is always outside.
Hemorrhoids are swollen blood vessels that may occur inside the rectum (internal) or outside the rectum (external). Hemorrhoids can usually be managed by eating a high-fiber diet and drinking eight to ten glasses of water per day. You may also need to use stool softeners to reduce straining during bowel movements.