Signs of Haemorrhoids (Piles) Rectal bleeding → Bright red blood seen on toilet paper, stool surface, or in the toilet bowl → Usually painless bleeding, most commonly from internal piles Anal pain or discomfort → Pain or burning sensation around the anus → More common in external or thrombosed haemorrhoids Itching around the anus → Persistent irritation or itching (pruritus ani) → Caused by mucus leakage and skin inflammation Swelling around the anus → Soft or firm swelling near the anal opening