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How to tell if you have hemorrhoids

Published 13 March 2026 ·Last reviewed 13 March 2026 by the editorial team ·How we create our content

At a glance

Suspecting you have hemorrhoids but not being sure is a common and anxious experience. The symptoms overlap with other conditions, the area is difficult to examine yourself, and the embarrassment of the location can delay seeking a professional opinion.

This guide describes the common signs and symptoms of hemorrhoids, what they typically look and feel like, and when getting a proper assessment is important.

Common symptoms

Bleeding

The most common hemorrhoid symptom:

  • Bright red blood — typically on the toilet paper, on the surface of the stool, or dripping into the toilet
  • Painless — internal hemorrhoids often bleed without any pain
  • Associated with bowel movements — occurs during or immediately after
  • Intermittent — may come and go, often worse during flares or with hard stools

Lumps and swelling

  • External hemorrhoid — a soft, sometimes tender swelling near the anus
  • Thrombosed hemorrhoid — a firm, hard, painful lump that appears suddenly (a blood clot within the hemorrhoid)
  • Prolapsed internal hemorrhoid — soft tissue that protrudes from the anus, usually during a bowel movement

Itching

  • Perianal itching is common with hemorrhoids
  • Often caused by mucous discharge from prolapsed internal hemorrhoids
  • Can also result from difficulty keeping the area clean

Discomfort and pain

  • Heaviness or fullness — a feeling of something being there
  • Discomfort with sitting — particularly on hard surfaces
  • Pain during bowel movements — more common with external hemorrhoids or if there is also a fissure
  • Throbbing pain — characteristic of a thrombosed hemorrhoid

Discharge

  • Mucous discharge — from prolapsed internal hemorrhoids
  • Soiling — difficulty keeping the area clean
  • Moisture — persistent dampness in the perianal area

What hemorrhoids feel like

External hemorrhoids

If you feel the area, an external hemorrhoid is typically:

  • A soft, rounded swelling near the anus
  • May be tender to touch during a flare
  • Covered by skin (not the red mucosa of the rectal lining)
  • May swell up and then reduce over days to weeks

Thrombosed hemorrhoid

  • Firm and hard — the blood clot makes it feel solid
  • Very painful, especially in the first 48 to 72 hours
  • May appear dark blue or purple under the skin
  • Does not reduce with gentle pressure

Prolapsing internal hemorrhoid

  • Soft, spongy tissue that protrudes during bowel movements
  • May feel like something falling out of the anus
  • Can usually be gently pushed back in (grade 2 or 3)
  • Pinkish or reddish — mucosal tissue rather than skin

What hemorrhoids are not

Symptoms that are less typical of hemorrhoids and warrant prompt assessment:

  • Dark blood mixed into the stool (rather than bright red on the surface)
  • Unexplained weight loss with bowel symptoms
  • Persistent change in bowel habits — new constipation, diarrhoea, or narrower stools
  • Pain that is constant rather than associated with bowel movements
  • A hard, fixed lump that does not change with time
  • Anal discharge that is not mucous — pus suggests infection

Getting a diagnosis

What a GP will do

  • Ask about your symptoms — duration, character, triggers
  • Examine the area — external examination and usually a digital rectal examination
  • May use a proctoscope — a small tube with a light to visualise internal hemorrhoids
  • Discuss management based on their findings
  • Refer to a specialist if needed

Why professional assessment matters

Self-diagnosis is tempting but has limitations:

  • You cannot examine internal hemorrhoids yourself
  • Other conditions (fissures, fistulas, skin tags) can coexist with or mimic hemorrhoids
  • Rectal bleeding should always be assessed at least once to confirm the cause
  • A proper diagnosis directs appropriate treatment

The appointment is brief, routine, and much less uncomfortable than most people expect.

Common questions

How do I know if it is hemorrhoids or something else?

Hemorrhoids are the most common cause of bright red rectal bleeding and perianal lumps, but they are not the only cause. Other conditions — fissures, fistulas, skin tags, and less commonly polyps or other growths — can cause similar symptoms. A proper assessment by a clinician provides clarity. Self-diagnosis is reasonable for mild, typical symptoms, but any uncertainty or concerning features warrant professional evaluation.

Can I see hemorrhoids?

External hemorrhoids and prolapsed internal hemorrhoids may be visible or felt as lumps near the anus. Internal hemorrhoids that have not prolapsed cannot be seen without a medical examination using a proctoscope. If you can feel a lump, noting its characteristics (soft or hard, painful or painless, colour) is useful information for a clinician.

Do hemorrhoids always hurt?

No. Internal hemorrhoids often cause painless bleeding with no pain at all. External hemorrhoids are more likely to be painful, particularly if thrombosed. The level of pain is not a reliable indicator of severity — a painless but persistently bleeding hemorrhoid can be more significant than a painful but temporary one.

When to seek care Heavy bleeding or feeling faint? Get emergency help now. Emergency: 911

Not sure how urgent it is? Get help today.

  1. Emergency

    Heavy bleeding, black tarry stools, feeling faint, severe pain or trouble breathing.

    Call 911 or go to the ER.

  2. Today

    Fever, pain getting worse, a hot swollen lump, or trouble passing urine.

    Call your doctor or go to urgent care.

  3. Soon

    Bleeding or bowel changes nobody has checked, or anything lasting 3 weeks.

    Book a doctor’s appointment.

Feeling overwhelmed? Call or text 988, any time.

See all the signs

For this topic, get medical advice if you notice:

  • Any rectal bleeding should be assessed by a doctor
  • Severe pain from a possible thrombosed hemorrhoid
  • A lump that you cannot identify
  • Symptoms that are worsening or not improving

Recording how you feel is not the same as being checked. These are the signs that need a doctor’s attention.

Call 911 or go to the emergency room now if you have:

  • bleeding that will not stop, a lot of blood (the toilet water turns red, or you pass large clots), or any bleeding with feeling faint or dizzy
  • fainting, a racing heart or trouble breathing
  • confusion or slurred speech, extreme shivering, no urine in a day, or blotchy skin
  • sudden severe belly pain, or a swollen, hard belly with vomiting or not passing stool or gas
  • you cannot pass urine at all, or your bladder feels full and painful and you can’t empty it
  • redness, swelling or severe pain spreading quickly around your anus, genitals or groin, especially with a fever or feeling very ill
  • a fever with a painful swelling near your anus if you have diabetes or a weakened immune system (for example, from chemotherapy or transplant medicines)
  • black, tarry stools

Call your doctor or go to urgent care today (or the ER if you can’t be seen today) if you have:

  • a temperature of 100.4°F (38°C) or higher, chills, vomiting, or feeling generally unwell
  • pain that is getting worse over days, or severe pain that stops you sitting or sleeping
  • a hot, swollen or very tender lump near your anus or at the top of the crease between your buttocks, or foul-smelling discharge
  • trouble urinating
  • bleeding that is getting heavier or more frequent, or blood mixed into your stool
  • feeling much more tired than usual, looking pale, or getting out of breath more easily than you used to
  • not passing stool for several days, or new belly pain

Make an appointment with your doctor if:

  • you have never had these symptoms checked by a doctor or nurse — whatever your age
  • you have had rectal bleeding for more than 3 weeks
  • your bowel movements have been looser, thinner or more frequent than usual for 3 weeks or more, or you have lost weight without trying
  • symptoms have not settled after a week or so, or keep coming back
  • you notice a new lump near your anus, between your buttocks or in your belly, or an itch or discharge that does not clear
  • you have new leakage or trouble controlling your bowels
  • you are 45 or over, or have a family history of bowel cancer or inflammatory bowel disease, and any of these symptoms are new for you

If you are unsure, it is always reasonable to ask. If things feel overwhelming, call or text 988 (Suicide & Crisis Lifeline) or chat at 988lifeline.org, any time. If you don’t feel safe, call 911.

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Related symptoms

BleedingPain during bowel movementsPain after bowel movementsItchingSwelling or lumpPressure or fullnessProtrusion

Discreet symptom tracking

Symptoms that come and go? Keep track, day by day.

For hemorrhoids, fissures, fistulas and other anal and rectal problems. A short, discreet email asks how things have been, and saves each answer, so you can look back at every flare and every good week in your own words. If you haven’t had your symptoms checked, see your doctor first.

  • About ten seconds a check-in. No app, no password.
  • Nothing in the subject or preview says what it’s about.
  • Each Sunday, a link to your week, ready for your next appointment.
Start tracking →

Your notes

Your check-in

Takes about ten seconds.

20:00
Example. Nothing on the lock screen hints at symptoms or conditions.

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