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Internal hemorrhoids are actually on the hemorrhoidal cushions, inside the anal canal, and you generally don't know that they're there until either they start bleeding or they prolapse, which means to poke outside the body.
Prolapsed internal hemorrhoids are a very, very bad thing, especially if they won't stay inside the body after a bowel movement, because the powerful anal sphincter can strangulate them and start causing them to go gangrenous.
However, most internal hemorrhoids are the garden variety that will subside on their own if treated properly, and, as a bonus, they generally don't hurt badly as they're in a part of the body without many nerves.
External hemorrhoids, which occur on the outside of the body, are a whole different matter in the pain department. They don't occur on the hemorrhoidal cushions themselves, but rather on the veins that run below them before going back up to the heart.
What they do occur on, however, is the extremely sensitive and dense band of nerves that serves to keep the anal sphincter closed. For this reason, external hemorrhoids can make anyone's life absolutely miserable.
Itchiness, pain and bleeding are all symptoms of hemorrhoids, as is an occasional mucus discharge from the general inflammation of the area.
Why is this important to know?
The home treatment you choose is highly dependent on the type of hemorrhoid you have.
External hemorrhoids can be treated by a whole of different creams and solutions that can be easily applied.
Internal hemorrhoids cannot be treated so easily, as placing the cream or solution into your rectum, or onto a prolapsed hemorrhoid, means you are placing it on the digestive membranes - the mucus membranes.
Anything placed on the digestive membranes is far more quickly and far more readily absorbed by the body. So a cream strong enough to take out an external hemorrhoid, is considered way overpowered for an internal or prolapsed one.
In fact, the risks are so great that NO drug company has succeeded in making a cream which the FDA considers safe for human use.
Think about it, would you consider swallowing the hemorrhoid cream or solution? No you wouldn't and there are probably warnings about taking it by mouth. Sticking it into your bottom is almost the same as putting it into your mouth.
Why are prolapsed ones included with internal hemorrhoids, when they are hanging outside?
The reason is that the prolapsed ones are covered by the same mucous lining as the internal ones are and, it's the mucous lining that absorbs things so very well.
Treatments for both types:
Of course, there are some treatments, such as sitz baths, that can be used for both internal and external ones. Such treatments do not rely on being absorbed in any way, but instead work by relaxing muscles and increasing blood flow.
Tablets are more a long term attempt at treating hemorrhoids. The idea is that they strengthen and rebuild the veins, while providing a strong pain killers. Such tablets tend be herbal in nature and use herbs like butchers broom.
In conclusion:
To conclude, finding out what type of hemorrhoid problem you have, is absolutely necessary to properly and safely deal with your hemorrhoids.
Anything that claims to treat an external hemorrhoid, is expected to be too powerful for use on an internal one, while any cream or lotion designed for an internal one, is likely to be too low in active ingredients for an external one.
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