Dr. Amir Bastawrous explains the symptoms of hemorrhoids. Internal hemorrhoids will present with bleeding, bowel movements, or prolapse where part of the hemorrhoid tissue will come out of the anus and goes back in by itself or by pushing it back in. They are usually painless. External hemorrhoids are painful and there is swelling. They are outside the anus. Rarely, do patients need surgery for hemorrhoids. However, It is important to see your physician if you have any bleeding from your anus. Please see the Swedish Medical Center website for more information: http://www.swedish.org/Services/Colon-and-Rectal-Clinic/Services/Hemorrhoids#Causes