Mixed hemorrhoids are usually characterized by bleeding and prolapse, but if there is pain, it is usually one of two things: a thrombosed external hemorrhoid or a combined anal fissure. You need to pay attention to two pieces of information: first, whether there is a prolapsed swelling or a feeling of incomplete defecation after a bowel movement; second, how long the above symptoms have been present. If the first problem is present, it is definitely a mixed hemorrhoid, and if the second problem is more than a month old, then the fissure may be chronic. If you only have mixed hemorrhoids with blood in the stool, or if the ulcerated surface of the fissure is fresh, you can be cured by conservative treatment; if you have third or fourth degree mixed hemorrhoids or old fissure, you often need surgery, and if your current conservative treatment is not effective, you should receive surgery early. It is still recommended to seek early medical treatment.