A characteristic feature of symptomatic internal haemorrhoids is painless, bright red bleeding or a protrusion from the rectum, which often follows a bowel movement. Pain may accompany complication of haemorrhoids. The presence of altered bowel habit (diarrhoea and/or constipation), abdominal pain, weight loss, iron-deficiency anaemia, or passage of blood clots and/or mucus (especially if persistent) should arouse suspicion of other potential diagnoses such as anal fissure, anal fistula, proctitis, inflammatory bowel disease, or colorectal cancer.
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