This situation might involve both internal and external hemorrhoids, which is referred to as mixed hemorrhoids. Internal hemorrhoids might also prolapse, leading to inflammatory edema and causing anal swelling and pain. External hemorrhoids can also present with inflammatory edema and thrombosis, leading to anal swelling and pain. Hence, in clinical practice, this situation is often considered as mixed hemorrhoids. Mixed hemorrhoids mainly occur at the same point in the anal canal, both above and below the dentate line, and symptoms of both internal and external hemorrhoids are present. Clinically, if the patient is unwilling to undergo surgery, conservative treatment with medication can be considered initially, such as oral administration of Diosmin tablets, followed by the use of an anal wash or a sitz bath with potassium permanganate solution after defecation, and then application of Dihuang ointment externally to alleviate discomfort. However, if the inflammatory edema does not subside and anal swelling and pain are significant, it is advised to consider surgical intervention early to prevent necrosis due to prolapsed hemorrhoids. (Please follow medical advice when using medications.)