In reference to symptoms, internal hemorrhoids are located a little bit higher up and their nerve supply is different from that of an external hemorrhoid. Basically, internal hemorrhoids, uncomplicated, are oftentimes painless. However, if they're scratched or abraded, you may see some blood per rectum or on the toilet tissue. Now, external hemorrhoids, their nerve supply is different. It's very similar to the nerve supply of your skin, and so you can imagine if you were to pinch your skin, or scratch your skin, that would be painful. And so external hemorrhoids are characterized more by pain than internal hemorrhoids, which are otherwise uncomplicated. Again, if you notice bleeding from external hemorrhoids, you should definitely bring that to the attention of your physician.