The main symptom of stage four internal hemorrhoids is the protrusion of the nucleus. Stage four internal hemorrhoids are more serious because of the protrusion, so the bleeding caused by the stool rubbing against the hemorrhoid during defecation is reduced, so the bleeding symptom of stage four internal hemorrhoids is not serious, and the main symptom is the protrusion. The hemorrhoid cannot be retracted by itself after defecation, but it needs to be retracted by hand, but even after retracting by hand, the nucleus of the hemorrhoid will come out again within a short period of time, and the internal hemorrhoid is usually not accompanied by pain. However, stage 4 internal hemorrhoids, because of the rectal mucosa on the surface, secrete mucus, which irritates the perianal skin and causes itching around the anus. In comparison with external hemorrhoids, internal hemorrhoids are relatively more harmful to people, and if there are serious internal hemorrhoids with bleeding symptoms, anemia may occur, and long-term prolapse may also lead to serious complications such as localized necrosis of the embedded hemorrhoid nucleus.