Internal hemorrhoids are located in the rectum. They may not cause pain initially. Symptoms may include bright red blood coating stools in the toilet, or on the toilet tissue after wiping. If a clot forms in the vein, or if it becomes infected or injured, pain may be severe. Over time, internal hemorrhoids may become large enough to protrude through the anus, appearing as reddish, moist masses, and can result in chronic fecal leakage and soiling.
External hemorrhoids appear as very tender, sometimes itchy, bluish swellings at the anus.
They frequently cause bleeding and anal spasms, making defecation painful, and causing further constipation. Anal fissures are small, superficial, painful cracks in the lining of the anal canal, often caused by the passage of hard, irregularly shaped stools. They can cause spasms and painful defecation. Preventing and Treating Constipation Pay attention to the urge to move your bowels. It usually occurs shortly after eating a meal or following exercise.