Hello, I understand your concern, and reading about your question I understand that you have some great information about your health. From your description, I also think that you have internal hemorrhoids. External hemorrhoids in the most of the casese are accompanied with internal hemorrhoids. I would like to know more about the pain, other sign and symptoms ( for ex fever, bleeding, constipation) or the diet the last days. However, if there are or not those symptoms, the way you describe I think it looks like strangulated hemorrhoids. So , I think you must to go to a doctor because it can infect or worst, thrombosed hemorrhoids. Take care! I wish my answer was helpful to you! Regards, Dr Eniola