internal vs external hemorrhoidsHemorrhoids are not a normal topic of conversation among most groups of people and, more often than not, are associated with embarrassment. That should not be the case because hemorrhoids are extremely common, effecting over half of the world’s population. You also might not know that there are two types of hemorrhoids, and only a hemorrhoid doctor can distinguish between internal vs. external hemorrhoids.

Dr. Nowain has years of experience diagnosing and treating all types of hemorrhoids and he’s helped thousands of people increase their everyday quality of life. It’s important for patients to stay informed about their bodies and the possible problems that can happen, that’s why Dr. Nowain created this page as a reference.

Difference Between Internal vs. External Hemorrhoids

Hemorrhoids are engorged veins within the lower anus and it’s important to know that there are two different types: internal versus external hemorrhoids. Unfortunately, it can be difficult to diagnose one from the other, that’s why it’s so important to see an expert gastroenterologist like Ari Nowain, MD.

External Hemorrhoids

External hemorrhoids usually occur as painful, discolored (usually purple) bumps. This type of hemorrhoids is usually painful because it is below and around a line of nerve endings called the dentate line. Clusters of nerve endings surround anything below this line, while anything above it does not have any nerve endings.

Some of the common symptoms associated with external hemorrhoids are bowel movement pain, pressure around and/or near the anus, a bump/bulge near the anus, bleeding, and itching. External hemorrhoids are frequently confused with anal fissures, which are actual cracks in the skin. Common symptoms for anal fissures are pain, blood, itching, and the feeling of internal cutting while having a bowel movement. Over-the-counter medication does not get to the root of either external hemorrhoids or anal fissures, that’s why it’s important to see a gastroenterologist like Dr. Nowain to get help as quickly as possible. While temporary relief is possible without a GI doctor, it cannot substitute the attention, care, and experience that Dr. Nowain gives to all of his patients.

Internal Hemorrhoids

Unlike external hemorrhoids, internal hemorrhoids are above the dentate line and are generally painless because they lack nerve endings. However, similar to external hemorrhoids, big and prolapsed internal hemorrhoids can be seen externally, making it confusing for both patients and even some doctors. That’s one of the main reasons why both types of hemorrhoids are so difficult to diagnose. Another commonality between the two that makes them hard to correctly diagnose is that both have very similar symptoms. Internal hemorrhoids symptoms include bumps, itchiness, bleeding, and can create a dull feeling of anal pressure.

Internal hemorrhoids treatment is easy, is effective, and is called rubber band ligation or hemorrhoid banding. The entire procedure takes one minute to complete and doesn’t require any anesthesia. Dr. Nowain is a huge proponent for this procedure over other internal hemorrhoid procedures because of its efficiency and short downtime.

Book Your Hemorrhoid Banding Appointment

Dr. Nowain is a double board certified Beverly Hills gastroenterologist who oversees the Center for GI Health. He specializes in knowing the difference between internal versus external hemorrhoids, hemorrhoid removal, and hemorrhoid band ligation. If you or someone you know is interested in consulting with Dr. Nowain about removing their hemorrhoids, please contact his office at (310) 657-4444.

Find out about Hemorrhoid Banding Ligation.