Internal hemorrhoid bleeding should be differentiated from the following diseases: 1. Rectal cancer. This disease may have the discomfort of anal swelling and a history of blood in the stool, but the blood in the stool is mucus blood stool and mixed with stool, dark red or jam color. Most of the rectal cancer can be felt on the dentate line during finger diagnosis, and the mass on the wall of the rectal canal is hard, with uneven edges, poor mobility, and protruding into the intestinal cavity, and the protruding mass can be seen on anorectoscopy, mostly cauliflower-shaped, with ulcers or bleeding, and the diagnosis can be confirmed by taking biopsy for pathological examination. 2.Low rectal polyps. Benign rectal tumors, mostly seen in children, the main symptom is also painless blood in the stool, low polyps with tips can come out of the anus, such as a “red cherry” with a handle. It can be removed by electrocautery or ligation, and the prognosis is good. 3. Anal fissure. It is characterized by blood in the stool with severe anal pain and a history of constipation, while internal hemorrhoids are usually painless when they bleed. The fissure can be seen as a longitudinal rupture or ulcer in front or behind the anal verge, and there is a hyperplastic connective tissue external hemorrhoid at the distal end of the fissure, which is like a sentinel of the anal fissure and is often imaginatively called “anterior sentinel hemorrhoid”. 4. Rectal prolapse. It is easy to misdiagnose as mixed hemorrhoids, but the sphincter muscle is found to be relaxed during rectal finger examination, commonly known as “prolapse”. 5.Anal papillae hypertrophy. Located on the dentate line, conical, white surface, infrequent bleeding. 6.Lower gastrointestinal bleeding. It is easily mistaken for hemorrhoid bleeding and needs to be differentiated. Hemorrhoid bleeding is characterized by dripping or shooting blood with stool, bright red blood, and does not mix with stool; lower gastrointestinal bleeding has many causes, including inflammatory, tumor, etc. The bleeding is mostly pus and blood or mucus and blood stool or with necrotic tissue, which mixes with stool. To confirm the diagnosis, sigmoidoscopy, culture of fecal pathogenic bacteria and barium enema double imaging are required.