Prolapsed Hemorrhoids: Symptoms, Stages, and Proven Treatment Options

Prolapsed hemorrhoids are a common condition that affects millions of adults worldwide. Unlike internal hemorrhoids, which stay inside the rectum, prolapsed hemorrhoids extend outside the anal canal, forming a visible bulge. This can cause discomfort, irritation, pain during sitting, and difficulty during bowel movements. Early recognition, proper management, and preventive measures are essential to reduce symptoms and avoid complications. For a complete overview of hemorrhoids, visit our main Hemorrhoids guide.

Anatomy and Function: Why Prolapse Happens

The anal canal contains natural cushions of tissue called hemorrhoidal cushions, which are rich in blood vessels and help maintain continence. When these cushions become enlarged due to increased pressure, weakened connective tissue, or straining, they can protrude outside the anus, leading to prolapsed hemorrhoids. This explains why conditions such as chronic constipation, pregnancy, and obesity increase the risk. To understand the different types, see our Types of Hemorrhoids page.

Classification of Prolapsed Hemorrhoids

Prolapsed hemorrhoids are graded by severity:

Grade 1: Hemorrhoids remain inside the anal canal.
Grade 2: Prolapse occurs during bowel movements but retracts naturally.
Grade 3: Prolapse requires manual reduction.
Grade 4: Permanently prolapsed hemorrhoids that cannot be manually reduced.

For additional types, refer to Internal Hemorrhoids and External Hemorrhoids. Understanding the classification helps determine the best treatment approach.

Causes and Risk Factors

Several factors contribute to prolapsed hemorrhoids:

Chronic Constipation: Straining increases pressure on rectal veins, causing tissue to prolapse.
Prolonged Sitting: Sitting, particularly on the toilet for long periods, adds pressure to the anal cushions.
Pregnancy: Hormonal changes and increased abdominal pressure can lead to prolapse.
Low-Fiber Diet: Hard stools from insufficient fiber cause straining and increase the risk.
Obesity: Excess body weight adds pelvic pressure, worsening prolapse.
Heavy Lifting and Aging: Weakening tissues and repeated strain contribute over time.
Chronic Diarrhea: Frequent bowel movements and irritation can promote prolapse.

Addressing these factors through lifestyle changes, diet, and exercise is critical. Learn more in our High-Fiber Diet and Lifestyle Changes for Relief guides.

Symptoms to Watch For

Prolapsed hemorrhoids present noticeable symptoms:

Visible Lump: A swollen, soft mass protrudes from the anus, often during bowel movements.
Pain or Discomfort: Pain can range from mild irritation to severe soreness, especially when sitting or walking.
Bleeding: Bright red blood may appear on toilet paper or in the toilet bowl.
Itching and Irritation: Exposed tissue often causes itching or a burning sensation.
Mucus Discharge: Some may notice mucus leaking from the prolapsed tissue.

Understanding these symptoms helps differentiate prolapsed hemorrhoids from Thrombosed Hemorrhoids or other anal conditions. For more details, see our Hemorrhoid Symptoms & Diagnosis cluster.

Non-Surgical Management

Mild prolapsed hemorrhoids often improve with conservative measures:

Sitz Baths: Soak the anal area in warm water for 10–15 minutes, 2–3 times daily to relieve swelling and discomfort.
Topical Treatments: Creams with witch hazel, aloe vera, or hydrocortisone reduce inflammation and itching.
Dietary Fiber: Increase fruits, vegetables, and whole grains to soften stools.
Hydration: Drinking sufficient water ensures smooth bowel movements.
Manual Reduction: For Grade 3 prolapse, gently pushing the tissue back inside can relieve discomfort temporarily.

Daily lifestyle adjustments, such as avoiding prolonged sitting and practicing proper toilet posture, can prevent worsening. More home remedies are available on our Home Remedies for Hemorrhoids page.

Medical and Surgical Options

Persistent or severe prolapsed hemorrhoids may require medical treatment:

Rubber Band Ligation: A band is applied at the base to cut off blood supply, causing the hemorrhoid to shrink.
Sclerotherapy: Chemical injection shrinks hemorrhoid tissue.
Infrared Coagulation: Infrared light coagulates the tissue to prevent bleeding and further prolapse.
Hemorrhoidectomy: Surgical removal is recommended for Grade 4 or complicated cases.

Learn more on our Medical Treatments for Hemorrhoids page. Trusted guidance is also available via the Mayo Clinic Hemorrhoids Guide.

Prevention Strategies

Preventing recurrence focuses on lifestyle and bowel habits:

Eat a high-fiber diet to prevent constipation.
Stay hydrated to soften stools.
Avoid prolonged sitting or straining during bowel movements.
Exercise regularly to improve circulation.
Respond promptly to bowel urges and maintain proper toilet posture.
Use ergonomic seating and avoid heavy lifting when possible.

More prevention strategies are discussed in our Preventing Hemorrhoids Recurrence guide.

FAQs About Prolapsed Hemorrhoids

Can prolapsed hemorrhoids go back inside naturally? Grade 1–2 may retract on their own, but Grade 3–4 often require manual reduction or medical intervention.
How long does recovery take after treatment? Non-surgical methods usually provide relief within days, while surgical recovery may take 2–4 weeks.
Are prolapsed hemorrhoids dangerous? They are rarely life-threatening but can lead to complications like anemia, chronic prolapse, or infection if untreated.

When to Seek Medical Attention

Seek professional care if you notice severe pain, excessive bleeding, inability to reduce prolapsed tissue, or signs of infection such as pus or fever. Early intervention prevents complications, which are discussed in our Hemorrhoid Complications cluster.

Conclusion

Prolapsed hemorrhoids are manageable with proper care, early recognition, and lifestyle adjustments. Understanding their causes, symptoms, and treatment options ensures effective relief and prevents progression. Differentiating prolapsed hemorrhoids from Internal Hemorrhoids or Thrombosed Hemorrhoids helps select appropriate interventions. For comprehensive guidance, explore our full guides on Types of Hemorrhoids and Medical Treatments.