The hemorrhoids that are not painful are mainly internal hemorrhoids because they are located on the dentate line (the line dividing the anal canal from the rectum) and are innervated by the visceral nerve, which is not sensitive to pain, so they are not painful despite symptoms such as bleeding. The main hemorrhoids that cause pain are external hemorrhoids and mixed hemorrhoids as well as internal hemorrhoids that are embedded, especially thrombosed external hemorrhoids and inflammatory external hemorrhoids that are the most painful, because external hemorrhoids are located below the tooth line and are innervated by the spinal nerve, which is a nociceptive nerve, so they are sensitive to pain after the disease. The pain is also obvious when the anal verge is swollen and thrombosis is formed when the internal hemorrhoid is embedded. One foreign scholar said, “Do not treat symptoms without anal signs, and do not treat anal signs without symptoms”. Anal signs refer to hemorrhoidal changes found on local examination of the anus, and symptoms refer to blood in the stool, prolapse, anal dampness, anal itching and anal pain. This passage means that only when both symptoms and anal signs are present does it make sense to treat them surgically. It is generally believed that hemorrhoids with only local signs do not require immediate surgical treatment, but it is still very beneficial to have surgery as early as possible when clinical symptoms of hemorrhoids appear. For example, bleeding hemorrhoids, if left untreated for a long time, can lead to pernicious anemia and cause serious damage to the body; prolapsed hemorrhoids, if not treated with surgery in a timely manner, are likely to result in embedded necrosis of the prolapsed hemorrhoid nucleus, which not only causes severe pain, but also causes hemorrhage and leaves sequelae after surgery.