Prolapsed Hemorrhoids – Causes, symptoms, diagnosis, and treatment

What is Prolapsed Hemorrhoids?

Prolapsed Hemorrhoid is the bulging (prolapse) of hemorrhoid through the anus. Hemorrhoid happens due to the swelling of a vein in the lower rectum (lowest part of the intestine). A prolapsed hemorrhoid is usually not painful but causes discomfort while passing stool, sitting, and other day-to-day activities. A prolapsed hemorrhoid is graded from stage one to four depending on the extent to which it sticks out of the anus, with stage four being the advanced stage that requires immediate medical attention.

Types of Hemorrhoids

Internal hemorrhoid:
Internal hemorrhoid occurs within the rectum. It becomes a prolapsed hemorrhoid only when it bulges outward from the anus.

External hemorrhoid:
External hemorrhoid occurs directly on the anus. It may also become prolapsed if the swelling bulges out from the anus.

Is rectal prolapse and hemorrhoid the same?

Though the symptoms are common for rectal prolapse and hemorrhoid, they are not the same. Rectal prolapse happens when the attachment that keeps the rectum within the body is lost, and so, the rectum falls out through the anus. A hemorrhoid is the protrusion of the tissues in the lower rectum of the intestine. Hemorrhoid occurs more commonly than rectal prolapse in humans. Rectal prolapse may require a definitive surgery whereas hemorrhoid’s treatment may be from an invasive procedure to surgery. Rectal prolapse causes fecal incontinence. (Inability to control the passing of gas or stool)

Signs and Symptoms of a prolapsed hemorrhoid

  • Bleeding in the rectum – Bright red watery blood will bleed during the bowel movements.
  • Discharge of mucus – Mucus discharge from the anus happens due to prolapsed hemorrhoid.
  • Severe constipation – Inability to excrete the stools regularly causing intense constipation.
  • Diarrhea – The bowel movements happen continuously leading to dehydration.
  • Protrusion of rectal tissue – The swollen tissue sticks out through the anus.
  • Itchy sensation in the anus – The skin area at the prolapsed hemorrhoid may be itchy.
  • Pain during straining – Severe pain during the bowel movements and other straining activities.

When to consult a doctor?

  • If hemorrhoid doesn’t gradually reduce on its own and cause excessive discomfort that hinders the routine activities.
  • Irregular bowel movements leading to other digestive problems.
  • Sudden excessive bleeding from the anus.
  • The bulge of the lump becomes too big.
  • Reddened and itchy skin around the anus.

Timely consultation of a medical expert for prolapsed hemorrhoid will help in treating it using simple home remedies or medications as suggested by the expert. In certain cases, surgical treatment will also be recommended by the doctor to prevent any life-threatening situations.


A prolapsed hemorrhoid is caused due to the pressure in the blood veins of the rectum. Among the causes that lead to the prolapsed hemorrhoid, the following causes are significant. Let us discuss them in detail:

  • Overweight/obese
    Lack of physical activity results in increased body mass index. This, results in the building of fat layers that exerts pressure on the walls of the rectum and cause prolapsed hemorrhoid.
  • Irregular bowel movements (Diarrhoea or constipation)
    Bowel movements have to be regular to avoid digestive problems like diarrhea and constipation. Diarrhea results in the loosening of the rectal muscles whereas constipation increases the force exerted on the rectal muscles. Both the problems cause prolapsed hemorrhoids.
  • Excessive straining activities
    Involving in excessive anal straining activities like sitting in the bathroom for a long time due to difficulty in pushing the fecal matter easily. This also increases the grade of prolapsed hemorrhoids.
  • Low fiber food/high-fat food
    This is a leading cause of prolapsed hemorrhoids. Intake of food with low fiber content or high-fat content leads to dehydration which results in the deterioration of the anal cushions.
  • Pregnancy and post-pregnancy
    An enlarged uterus exerts pressure on the anal canal which leads to the sticking out of tissue through the anal. Prolapsed hemorrhoid happens the most during the post-pregnancy period in women.
  • Old age factor
    With progressing age, the tissues and muscles around the anal tract start to loosen resulting in the prolapsed hemorrhoid.
  • Cigarette smoking
    Researches have shown that cigarette smoking increases the risk of prolapsed hemorrhoid.

Associated Risk factors

There are few complications associated with a prolapsed hemorrhoid. Advanced hemorrhoids will completely obstruct bowel movement leading to other digestive problems. In some cases, prolapsed hemorrhoid starts to bleed or gets strangulated which requires immediate medical help. Infection of the anal area is also another risk factor.

How is prolonged hemorrhoid diagnosed?

Doctors perform tests to determine the existence of prolapsed hemorrhoids and their grades to decide upon the next course of medical help required by the patient. Physical examination of the anus is the first and foremost diagnosis step to check the prolapsed hemorrhoid that is visible and conclude its severity.


Common self-care tips that can be done to avoid prolapsed hemorrhoid or its worsening are as follows:

  • Warm baths
  • Ice packs
  • Intake of high fiber food
  • Maintaining a good physique by staying active
  • Sufficient hydration (intake of fluids)
  • Avoid smoking

Medications (ibuprofen (Advil, Motrin) or acetaminophen (Tylenol)) prescribed by doctors can be taken regularly to counter the effects of prolapsed hemorrhoids. Sometimes doctors give you stool softeners and ointments to ease the pain.

In extreme cases, surgical procedures are also required to prevent the further complication of prolapsed hemorrhoid. Hemorrhoidopexy, Hemorrhoidectomy, Infrared coagulation, sclerotherapy, and rubber band litigation.

Sclerotheraphy – In this procedure, the doctor injects chemicals into hemorrhoid that results in the shrinking of the tissues. This is recommended for grades 1 and 2 of prolapsed hemorrhoid.

Coagulation – This process is the hardening of hemorrhoids using a laser, heat, or infrared light. Hardening helps in dissolving hemorrhoids.

Rubber band litigation – The doctor places one or two rubber bands tightly around hemorrhoid so the blood supply to it is cut off and wears out in a week.

Recovery time

After surgery, it takes 4 to 8 weeks to recover and resume normal activities. The doctor will insist to have the first bowel movement within 48 hours of operation with the help of stool softening medications.