Internal hemorrhoids are swollen veins inside the rectum. Because they sit above the pain line, they usually bleed and bulge without hurting.

Painless bleeding is the hallmark. Bright-red blood drips into the bowl or shows on the toilet paper after you wipe.

Protrusion follows. A soft, pink lump may slide out during bowel movement and either pop back in on its own or need a gentle push.

Itching and wetness occur when the hemorrhoid leaks mucus, irritating the skin around the anus.

Feeling of fullness is common. You sense something is still there even after you finish stooling.

Pain is rare unless the hemorrhoid twists or clots; then a deep, dull ache starts.

Late signs include a hard, painful lump or continuous bleeding—an alarm that the vein has clotted.