If a thrombus does not form, external hemorrhoids will most likely cause minor pain. External hemorrhoids covered in skin can be seen and cannot be sent into the anus. These types typically will not bleed and the main symptoms are pain and foreign body sensation.

Internal hemorrhoids has the highest morbidity. Internal hemorrhoids refer to a disease- varicose mass, covered with mucosa, occur above the dentate line of anus. Its main symptoms are bleeding in the toilet, internal hemorrhoids partly prolapse and constipation. Patients with internal hemorrhoids usually have painless, but bright red rectal bleeding during defecation or after defecation. The blood usually covers the feces (called bleeding in the toilet), dip onto toilet paper, or drip into the toilet. If the internal hemorrhoids experience thrombosis or necrosis, patients usually will experience tremendous pain.