Many people want to be able to recognize a hemorrhoid, because it can be difficult to assess whether what you see or feel at the anal opening is “just” a hemorrhoid, or if it could be something else. A hemorrhoid is an enlargement of blood vessels in and around the rectum, and its appearance varies especially depending on whether it is internal or external. Below you will find a practical guide to typical characteristics, what to look out for at home, and when it is relevant to contact a doctor.

Internal hemorrhoids are located inside the rectum and therefore often cannot be seen from the outside. Some people only discover them through symptoms such as fresh, red blood on toilet paper or in the toilet after a bowel movement. When an internal hemorrhoid grows larger, it can intermittently “bulge out” at the anal opening, especially during bowel movements, and then retract again.

A typical appearance, if visible, can be described as a smooth, moist bulge in mucous membrane colors or a reddish hue. However, it is important to know that a definitive diagnosis cannot be made based on appearance alone.

External hemorrhoids are located at or just outside the anal opening and are therefore more often visible or palpable. They can resemble a small soft or firm lump, a swelling, or a skin fold. The color can vary from skin-colored to reddish.

If a blood clot forms in an external hemorrhoid (thrombosis), it may appear more tense, tender, and often bluish or purple. In cases of severe pain or rapid change in size, it is a good idea to have it evaluated.

Hemorrhoids can look different from person to person. What is typically described is:

• Shape: bulge, lump, or "cushion-like" swelling at the opening
• Surface: smooth and moist (often internal), or more skin-like (often external)
• Color: skin-colored, reddish, or bluish with a blood clot
• Size: from small swellings to more pronounced prolapse under pressure

Ask yourself:

1. Is it visible from the outside, or mostly felt internally?
2. Is there fresh red blood after a bowel movement?
3. Is there pain, or mostly itching/irritation?
4. Is the lump soft, or very hard and tender?

If in doubt, a clinical assessment is the safest approach.

The appearance is often linked to what you feel. Common signs can include itching, burning, irritation, and a feeling of "something being squeezed." Fresh bleeding can occur, especially with internal hemorrhoids, but rectal bleeding should always be taken seriously until the cause is clarified.

Contact a doctor if you have:

• persistent or heavy bleeding
• severe pain, fever, or a compromised general condition
• a lump that does not subside or changes rapidly
• unexplained weight loss or altered bowel habits over time

If the symptoms are new, persistent, or concerning, it is relevant to talk to a doctor. Hemorrhoids can usually be assessed through a conversation, a general examination of the area, and possibly an internal examination. This involves both confirming whether it is hemorrhoids and ruling out other causes of lumps or bleeding, for example.

As a rule of thumb: If you cannot calmly explain your symptoms, it is worth getting it checked out.

For example, if you are pregnant or have recently given birth, the area may feel extra sensitive, and gentle care can be pleasant. An intimate wash bottle can make it easier to keep clean without irritation, for example, the Intimate Care Wash Bottle. If you are in the postpartum period, a complete care solution can also be practical, such as the New Mum Care Pack.

Sources (brief): Lex.dk on hemorrhoids (definition and internal/external) and general medical practice for assessing rectal bleeding.