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First degree: the hemorrhoids remain inside at all times. Second degree: the hemorrhoids extend out of the rectum during a bowel movement but return on their own. Third degree: the hemorrhoids extend out during a bowel movement but can be pushed back inside. Fourth degree: the hemorrhoid is always outside.
Hemorrhoids are veins in the rectum or anus that become swollen and painful. Sometimes they go away by themselves, but in other cases they can cause lingering pain, itching, and bleeding. There are two types of hemorrhoids: those that are just inside the anus or lower rectum (internal) and those that are outside the opening to the anus (external).