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In reference to symptoms, internal hemorrhoids are located a little bit higher up and their nerve supply is different from that of an external hemorrhoid. Basically, internal hemorrhoids, uncomplicated, are oftentimes painless. However, if they're scratched or abraded, you may see some blood per rectum or on the toilet tissue. Now, external hemorrhoids, their nerve supply is different. It's very similar to the nerve supply of your skin, and so you can imagine if you were to pinch your skin, or scratch your skin, that would be painful. And so external hemorrhoids are characterized more by pain than internal hemorrhoids, which are otherwise uncomplicated. Again, if you notice bleeding from external hemorrhoids, you should definitely bring that to the attention of your physician.

Doctor Profile

Eugene Trowers, MD, MPH, FACP


  • Board Certified by the American Board of Internal Medicine in General Internal Medicine and Gastroenterology
  • Graduated from the New York University School of Medicine in 1976 and has been in practice for over 42 years 
  • Listed in Best Doctors in America, and The Best Doctors in America: Central Region

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