Two Sides of the Same Coin - Internal and External Hemorrhoids

by Sharon Hopkins

Hemorrhoids (piles) affect most people at some time or the other in their lives. Hemorrhoids are the most common in people between the ages of 45 and 65. Pregnant women too, have a high risk of hemorrhoids due to the excess weight they carry.

Hemorrhoids are classified into two main types, internal and external. Let's take a look at what the differences are between the two and what can be done to treat them.

Internal and External Hemorrhoids

Both internal and hemorrhoids are characterized by swelling near the anus, and they are both caused by the same reasons which are:

  • Constipation
  • Straining
  • Low fiber in diet
  • Spending excessive time in the bathroom

So, what makes internal and external hemorrhoids, two sides of the same coin? Read on to find out.

Internal Hemorrhoids

  • Location: Lower rectum (the final part of the large intestine).
  • Usually not visible externally.
  • In some cases, internal hemorrhoids protrude outside and appear like external hemorrhoids. Usually these protruding hemorrhoids prolapse into the rectum on their own.

External Hemorrhoids

  • Location: Perianal marginal veins (under the skin near the anus).
  • Are visible externally, around the anus.

Symptoms of Internal Hemorrhoids

Apart from where they are located, internal and external hemorrhoids are differentiated based on their symptoms. Below are the symptoms observed in internal hemorrhoids.

  • Bright red blood when passing stools
  • Absence of pain in non-prolapsed cases
  • Anal discomfort and itching is rare
  • Prolapse when passing stools

Symptoms of External Hemorrhoids

External hemorrhoids are generally more bothersome when compared to internal hemorrhoids and are characterized by the following symptoms.

  • External swelling in the anus
  • Painful when passing stools
  • Bleeding when passing stools
  • Blood clots are formed
  • Sometimes they appear as hard lumps near the anus
  • In some cases, the blood clot dissolves and leaves sagging skin that itches

Internal and External Hemorrhoids Treatment

While internal and external hemorrhoids may have their differences, their cause being the same implies that their treatment options are also the same. Listed below are some of the treatment options for both internal and external hemorrhoids.

Lifestyle Changes

  • Drink plenty of water
  • Include a fiber rich diet
  • Exercise
  • Avoid spending a lot of time in the bathroom
  • Avoid straining while passing stools

Home Remedies

  • Warm water soaks
  • Ice baths


  • Stool softeners to smoothen bowel movements
  • Pain relief creams

Both internal and external hemorrhoids can be treated quite easily without any need for surgery. Internal and external hemorrhoids are essentially the same, which is a swelling caused because of hardened bowel movement. Hence, they are in a sense, two sides of the same coin.



Warning: The reader of this article should exercise all precautionary measures while following instructions on the home remedies from this article. Avoid using any of these products if you are allergic to it. The responsibility lies with the reader and not with the site or the writer.
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