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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.
Bleeding occurs when the intricate surface of the hemorrhoids are irritated during bowel movements, states Mayo Clinic. Also referred to as piles, hemorrhoids are inflamed and swollen veins in the lower rectum and the anus. This is a common condition and can be painful, but it's usually not severe.