Prolapsed Hemorrhoid

What is a prolapsed hemorrhoid?

A prolapsed hemorrhoid is when a swollen vein inside your rectum bulges outside of your butthole (anus). Before it prolapses, it’s inside your rectum, and you typically don’t even feel it. But then, increased pressure on your rectum forces the internal hemorrhoid to swell and eventually bulge out of your butthole.

Once it prolapses, you may notice symptoms like bleeding, itching or pain. You can usually feel a prolapsed hemorrhoid with your finger. If you use a mirror to look at your anus, you’ll see a soft lump around your butthole.

Prolapsed hemorrhoids don’t usually cause serious problems, but they can be uncomfortable. At-home and over-the-counter treatment can usually help relieve your symptoms. You may be able to gently push the prolapsed hemorrhoid back into your rectum. Surgery is sometimes necessary to completely get rid of the hemorrhoid.

What are the symptoms of a prolapsed hemorrhoid?

The biggest sign is a soft lump around your butthole. You can often see it or feel it. It can be the color of your skin or pinkish red.

Other symptoms of a prolapsed hemorrhoid include:

• Itching around your anus
• Feeling like you need to poop or that you have poop stuck after you wipe
• Bleeding or leaking mucus (clear or white fluid) from your anus
• Pain and discomfort, especially when you sit

What does a prolapsed hemorrhoid look like?

It looks like a small, fleshy bump that protrudes from your butthole. The exact size can vary. It’s typically soft. Sometimes, it can leak mucus.

What causes a prolapsed hemorrhoid?

A prolapsed hemorrhoid happens when a swollen vein inside your rectum bulges or sticks out of your anus. It’s usually due to your rectum being under increasing amounts of pressure. This pressure can happen when you strain to poop or bear down during activities like weightlifting.

Any internal hemorrhoid can prolapse. The following activities and conditions put you at risk for internal hemorrhoids:

• Frequent constipation
• Straining to poop
• Sitting on the toilet for long periods of time
• Pregnancy
• Obesity
• Frequent diarrhea

What are the complications of a prolapsed hemorrhoid?

They usually aren’t serious, but a prolapsed hemorrhoid can lead to complications. Some of those are:

• Strangulation (when the blood supply to the hemorrhoid is cut off)
• Thrombosed hemorrhoid (when a blood clot forms in the hemorrhoid)
• Bleeding (which can lead to anemia)
• Difficulties pooping or having bowel movements

Because of these complications, it’s always a good idea to tell your healthcare provider about a prolapsed hemorrhoid.

How is a prolapsed hemorrhoid diagnosed?

A healthcare provider can often diagnose a prolapsed hemorrhoid just by looking at it. They’ll also ask you questions about your symptoms and pooping habits. They can also perform one of the following tests if they need more information about the cause of your hemorrhoids:

• Rectal exam
• Anoscopy
• Rigid sigmoidoscopy

Grading scale for prolapsed hemorrhoids

Your provider uses a scale to grade how much the hemorrhoid bulges:

• Grade 1: No prolapse, but swollen blood vessels may be visible.
• Grade 2: The prolapsed hemorrhoid bulges when you strain, but will go back up into your anus on its own. For example, it protrudes when you poop but then goes back in after you’re done pooping.
• Grade 3: The prolapsed hemorrhoid bulges when you strain, but doesn’t go back up on its own. You need to push it back in yourself.
• Grade 4: The prolapsed hemorrhoid is always sticking out and can’t be pushed back in.

How is a prolapsed hemorrhoid treated?

Most prolapsed hemorrhoids get better with at-home care and being more mindful of your pooping habits. But this also depends on the severity of the prolapse and your symptoms.

Some at-home and over-the-counter treatments include:

• Taking sitz baths
• Keeping your poop soft and formed by eating a lot of fiber-rich foods
• Drinking lots of water
• Using topical ointments or creams containing hydrocortisone, witch hazel or lidocaine
• Using stool softeners or laxatives to make pooping less painful

While you’re trying these treatments, you should also evaluate your habits. For example, do you regularly sit on the toilet much longer than you need to? Do you need to eat more fiber or drink more water? All these things can go a long way in helping a hemorrhoid heal.

If at-home treatment isn’t working, your provider may recommend medical procedures to treat your hemorrhoid. This happens in less than 10% of cases. They may suggest:

• Rubber band ligation
• Sclerotherapy
• Transanal hemorrhoidal dearterialization (THD)
• Hemorrhoidectomy

Can prolapsed hemorrhoids go away on their own?

Yes. Sometimes, at-home care and changing your habits are all you need to do to help a prolapsed hemorrhoid go away.

But other times, the prolapse continues despite everything you’re doing at home to treat it. Your provider may need to perform a procedure or surgery to treat the hemorrhoid.

How long does it take for a prolapsed hemorrhoid to go away?

It depends on how severe the prolapse is. Mild prolapses can go away within a few days, especially if you’re using at-home treatments. More severe cases can take several weeks to go away, even when your provider uses a procedure to treat them.

How do I prevent a prolapsed hemorrhoid?

Any internal hemorrhoid has the potential for prolapsing. So, the best prevention is to reduce your risk of hemorrhoids altogether. Here are some tips:

• Avoid becoming constipated
• Make sure you eat enough fiber or take fiber supplements
• Don’t strain to have a bowel movement
• Go to the bathroom as soon as you have the urge
• Don’t lift heavy objects
• Exercise or move your body every day if you can

What can I expect if I have a prolapsed hemorrhoid?

A prolapsed hemorrhoid can be painful and uncomfortable. No one likes talking about it, and it can feel awkward to bring it up to your healthcare provider. But hemorrhoids are common, and you’re not the first person to have them.

The good news is that prolapsed hemorrhoids are treatable, often with at-home care. This doesn’t mean you shouldn’t let your provider know about it, though. Hemorrhoids can come back, so it’s a good idea to talk to your provider about ways to prevent hemorrhoids in the future. If you continue to get hemorrhoids or have hemorrhoids that affect your quality of life, your provider may suggest a procedure or surgery to help you.

When should I see my healthcare provider?

Contact your healthcare provider if you have a prolapsed hemorrhoid, especially if it’s causing you pain. Even if it’s not causing problems or heals on its own, your provider should know about it. Sometimes, other conditions can be confused with hemorrhoids, too.