Internal hemorrhoids rarely cause pain (and typically can’t be felt) unless they prolapse. Many people with internal hemorrhoids don’t know they have them because they don’t have symptoms. If you have symptoms of internal hemorrhoids, you might see blood on toilet paper, in your stool or in the toilet bowl. These are signs of rectal bleeding. Signs of external hemorrhoids include: Itchy anus. Hard lumps near your anus that feel sore or tender. Pain or ache in your anus, especially when you sit. Rectal bleeding. Prolapsed hemorrhoids can be painful and uncomfortable. You may be able to feel them bulging outside of your anus and gently push them back inside.