In some cases, blood clots form (thrombosed), causing a lot of pressure on the tissues. As the pressure increases, the pain becomes more severe and constant. When there’s too much pressure, the skin can sometimes break and blood starts to leak.
Defecating with external hemorrhoids can be very painful, and even sitting down or having pressure near the anus can also cause pain.
External hemorrhoids can sometimes go away on their own. However, medication or even surgery might be required in order to treat this type of hemorrhoid.
Internal hemorrhoids are hemorrhoids that are found above the pectinate line. These hemorrhoids are usually painless, but it’s possible for them to cause bleeding especially if a person strains while defecating or is constipated.
The reason why internal hemorrhoids are usually painless is because they are covered by a lining called “mucosa.” This mucosa is not sensitive to temperature, pain, or touch, so patients with internal hemorrhoids usually do not notice it until they experience bleeding.
Internal hemorrhoids usually go away on their own. However, if a person suffers from chronic constipation, then it’s possible for it to get worse.