External hemorrhoids: In some cases internal and external hemorrhoids are related, but not in every case. Usually need a scope or surgical exam to determine the status of internal hemorrhoids. This is actually good news for you.
Answered 10/20/2014
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External hemorrhoids: Usually the hemorrhoidal cushions or vein complexes originate internally. The shear forces secondary to either straining with constipation or frequent bowel movements associated with diarrhea can lead to prolapse of the anal lining ( mucosa) and associated hemorrhoids. If they clot or thrombose, they can be quite painful. When the acute inflammation resides you may be left with redundant skin.
Answered 7/10/2013
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