A first-degree internal hemorrhoid bulges into the anal canal during bowel movements. A second-degree internal hemorrhoid bulges from the anus during bowel movements, then goes back inside by itself. A third-degree hemorrhoid bulges from the anus during bowel movements and must be pushed back in with a finger.

Grade 1 hemorrhoids are treated symptomatically. There can be some spasm of the anal muscles. Warm sitz baths, sitting in a warm tub for 20 minutes, two or three times a day may be helpful. Avoiding spicy food may also prevent anal itching.

Most of the time, hemorrhoid symptoms go away after a few days even without treatment. If not, treatment focuses on relieving the pain. One of the most important steps in treating hemorrhoids is to avoid constipation. Hard stools can lead to rectal bleeding and/or a tear in the anus, called an anal fissure.

The standard classification of hemorrhoids consists of four grades, which describe what is happening to the internal hemorrhoids. Grade 1 hemorrhoids: these cause bleeding, but do not prolapse. Grade 2 hemorrhoids: these cause bleeding and also prolapse outside of the anus at the time of bowel movement.

Most hemorrhoids can be managed at home but if the pain or bleeding is severe; you are soiling yourself with stool; the hemorrhoids keep returning; or you are experiencing pain, bleeding and itching from the hemorrhoids after a week, consider seeing your doctor for assessment and treatment.

The pain of thrombosed hemorrhoids should improve within 7 to 10 days without surgery. Regular hemorrhoids should shrink within a week. It may take a couple of weeks for the lump to completely go down. You should be able to resume most activities right away.

Internal hemorrhoids may prolapse, which means they drop through the rectum and bulge from the anus. External or prolapsed hemorrhoids can become irritated or infected and may require surgery. The American Society of Colon and Rectal Surgeons estimates that less than 10 percent of hemorrhoid cases require surgery.