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Internal Hemorrhoids: First- to Fourth-Degree. A first-degree internal hemorrhoid bulges into the anal canal during bowel movements. A second-degree internal hemorrhoid bulges from the anus during bowel movements, then goes back inside by itself. A third-degreehemorrhoid bulges from the anus during bowel movements and must be pushed back in with a finger. A fourth-degree hemorrhoid protrudes from the anus all the time.
Hemorrhoids occur in two places. When they are located in the upper part of the rectum, the hemorrhoids are called internal hemorrhoids.In the lower part of the rectum, they are called external hemorrhoids. Hemorrhoids are said to be prolapsed if they have slipped down from their usual position and extend outside of the anal opening.ain during bowel movements and blood in the stool are the usual symptoms that accompany hemorrhoids. Sometimes there is a discharge of mucus, and there may also be itching, burning, or pain in the area. The enlarged vein in the rectum sometimes develops a clot, which can be very painful.