Internal Hemorrhoids: First- to Fourth-Degree

Picture of a first-degree internal hemorrhoid

Picture of a second-degree internal hemorrhoid

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. A fourth-degree hemorrhoid protrudes from the anus all the time.

Current as of: March 22, 2023

Author: Healthwise Staff
Medical Review:
Anne C. Poinier MD - Internal Medicine
Adam Husney MD - Family Medicine
Kenneth Bark MD - General Surgery, Colon and Rectal Surgery

The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.