One of the most common symptoms of internal hemorrhoids is bright red blood covering the stool, in the toilet, or on the toilet paper. An internal hemorrhoid, however, sometimes protrudes out through the anus outside of the body and becomes irritated and painful (protruding hemorrhoid). Although hemorrhoids are somewhat common, not everyone will experience symptoms.

Sometimes the excessive straining of a bowel movement, rubbing, or cleaning around the anus can cause bleeding and irritation. This often  produces a vicious cycle of symptoms.

The symptoms of external hemorrhoids usually include swelling that is painful or a hard lump around the anus. This lump is occurs when a blood clot forms (thrombosed external hemorrhoid).

Hemorrhoids are rarely dangerous or life threatening. Hemorrhoidal symptoms will go away within a few days in many cases.

There are several medical conditions that are often confused with hemorrhoids. These include:

• abscesses
• fissures
• fistulae
• prutiyus ani

For an accurate diagnosis, it is important that a physician evaluates any kind of bleeding from the rectum or any blood that is noticed in the stool. It is important to note that bleeding can also be a symptom of more serious gastrointestinal diseases such as colon cancer.

Physicians will usually examine the rectum and anus. They will look for common signs such as swollen blood vessels that can indicate hemorrhoids and may use a gloved finger to perform a digital rectal exam to find other abnormalities.

Sometimes it is necessary to use an anoscope to examine the rectum for hemorrhoids. An anoscope is a hollow, lighted tube that is used for examining internal hemorrhoids. Another device, a proctoscope, can be used to examine the entire rectum.Sometimes patients require a sigmoidoscopy or colonoscopy to make a complete diagnosis.

Pain or rectal bleeding can be an indication of a serious medical problem and patients experiencing any of these symptoms should be promptly evaluated by a physician.