Dr. Francis S. Lee, Advanced Surgical Care, M.C. - Advanced Laparoscopic, Da Vinci Robotic Surgeon
There are two different types of Hemorrhoids.

The external hemorrhoid is the type that is easily felt and more painful. The external hemorrhoid shows up at the outside of the anal opening. It usually becomes hard and indurated and inflammation can cause severe pain. It rarely bleeds but the thrombosis (firm clot formation) is more common. 

Internal hemorrhoids are more commonly seen in patients who complains of painless bright red bleeding while having a bowel movement. During the time the patient strains at the toilet, the internal hemorrhoid may show up as a protruding mass or it may simply bleed. Almost all of the internal hemorrhoids cause no pain, unless the Internal Hemorrhoid is very close to the anus and large protruding internal hemorrhoid or thrombosis can put some uncomfortable pressure to the anal canal. The internal hemorrhoid can be exacerbated by sitting on a toilet longer than necessary and standing or sitting too long. 

There are four grades of hemorrhoids and some hemorrhoids contain the both kinds together causing more severe symptoms. The treatments of various grade of hemorrhoid are quite diverse. There are medical treatments for mild hemorrhoids. There are office based procedures that can be easily done to stop the progression of internal hemorrhoids. Simple ligation of the bleeding hemorrhoid is available. Most of the external hemorrhoid can be treated in the office setting. Very few of the hemorrhoid will require surgery; however, it it gets to be bothersome, call our office for an appointment at 714-537-7766.