You can differentiate what type of hemorrhoid you have by knowing their location, description and the symptoms they produce. There are two types of hemorrhoids namely, internal and external hemorrhoids.

Internal hemorrhoids are hemorrhoids that are located inside the anus. They may lie far up inside the rectum, around 2 to 4 cm above the opening of the rectum so that you cannot see or feel them. They are usually painless due to few pain-sensing nerves in that location. This is also indicative that what you have is not severe.

Not so severe hemorrhoids may range from painless to producing mild discomfort, most especially when the stool accidentally brushes off with your hemorrhoid while defecating.

Usually, bleeding is the only sign that they do exist. Then, when you see a streak of bright red blood on the surface of your stool after defecating, you should suspect that you have internal piles, and that an appropriate consultation should be made.

Aside from bleeding, other signs of internal piles are itching and burning sensation of the anus and rectum. There is also the feeling of a need to defecate even after just finishing a round of painstaking bowel movement.

Internal hemorrhoids often are small swollen veins in the wall of the anal canal. They usually occur when the tissues supporting the veins in the anal canal weaken and get swollen, as tissues bulge into the anal canal.

These kinds of hemorrhoids can also be large, sagging veins that bulge out of the anus. When they protrude outside the anus, they can become very painful and irritated, most especially when squeezed by the anal muscles, most especially during the course of elimination.

When they protrude or get prolapsed , they are sometimes difficult to distinguish from external hemorrhoids. If the pain becomes severe, it may indicate that the blood supply to the hemorrhoids is severely reduced by the sphincter muscle of the anus, or worse has been totally cut off. At this point in time you can say that your hemorrhoids have gone bad! If this is the case, emergency treatment is highly recommended.

For treatment purposes, internal piles are graded according to their size and severity:

• Grade 1 shows a small swelling and located high up the anus. This is the common type and may enlarge further to grade 2 or higher
• Grade 2 is a hemorrhoid larger than grade 1. It may partly protrude the anus when you poop, but quickly ‘springs back’ inside again.
• Grade 3 protrudes from the anus, but can still be pushed back inside the anus with your finger.
• Grade 4 is often quite large and permanently protrudes from the anus and cannot be pushed back inside. This is the type that complicates into a thrombosed hemorrhoid.

Overall, even though internal hemorrhoids are not visible, painless and relatively harmless, it is a lot safer if you seek professional medical help, since bleeding is involved. You have to be 100% sure that the only cause of the bleeding is the presence of internal hemorrhoids and not some other existing disease.