The symptoms of hemorrhoids vary depending on whether they are located internally (inside the rectum) or externally (outside the rectum). Internal hemorrhoids are usually painless. However, if these enlarged veins are scratched or abraded, you may see some blood coming from the rectum or on the toilet tissue. External hemorrhoids have a different nerve supply, similar to the nerve supply of your skin, so external hemorrhoids are generally more painful than internal hemorrhoids are. If you notice bleeding from any type of hemorrhoids, contact your physician.