Internal hemorrhoids are swollen veins inside the lower rectum, and they often cause painless rectal bleeding rather than pain. They can also prolapse, meaning they may bulge out through the anal opening during bowel movements.

Common signs

  • Bright red blood on toilet paper, in the bowl, or on stool.
  • A feeling of tissue coming out of the anus.
  • Mucus discharge, itching, or burning.
  • Pain is less common unless the hemorrhoid is severe or prolapsed.

Why they happen

Internal hemorrhoids usually form when pressure builds in the veins around the rectum and anus. Common triggers include straining during bowel movements, sitting on the toilet too long, constipation, and sometimes heavy lifting.

Usual treatment

Many cases improve with:

  • More fiber and fluids.
  • Stool softeners if needed.
  • Warm sitz baths.
  • Avoiding straining and long toilet sitting.

If symptoms persist, doctors may use procedures such as rubber band ligation, sclerotherapy, or infrared photocoagulation.

When to get checked

Any rectal bleeding should be evaluated, especially if it is new, frequent, heavy, or comes with dizziness, weakness, weight loss, or major pain. Bleeding can have other causes besides hemorrhoids, so it is worth getting a proper diagnosis.

TL;DR: Internal hemorrhoids are swollen veins inside the rectum that often cause painless bleeding, itching, or a bulge, and they are usually managed first with fiber, fluids, and avoiding straining.[10][2][1]