Prolapsed Haemorrhoids Signs, Causes, and Effective Treatments
Know about the prolapsed haemorrhoids, signs, causes, diagnosis, prevention and treatment options.
Written by Dr. Mohammed Kamran
Reviewed by Dr. Shaik Abdul Kalam MD (Physician)
Last updated on 16th Sep, 2025
Introduction
Noticing a soft bulge or experiencing persistent discomfort around your anal area? You might be dealing with a prolapsed haemorrhoid, a common yet often distressing condition. A prolapsed haemorrhoid occurs when an internal haemorrhoid swells and extends outside the anal canal, leading to symptoms like pain, itching, and bleeding. Understanding what leads to these signs is the first step toward effective management and relief. This article will comprehensively guide you through everything you need to know, from identifying the initial symptoms and underlying causes to exploring a range of treatment options, from simple home remedies to professional medical procedures.
What Exactly is a Prolapsed Haemorrhoid?
Haemorrhoids are naturally occurring vascular cushions in the anal canal that help with stool control. A prolapsed haemorrhoid is specifically an internal haemorrhoid that has become so enlarged that it protrudes, or prolapses, through the anus. This can happen during a bowel movement and may retract on its own afterwards, or it may remain outside, requiring manual reinsertion or medical attention.
Consult a General Practitioner for Personalised Advice
Internal vs. External: Knowing the Difference
It's crucial to distinguish between internal and external haemorrhoids. Internal haemorrhoids lie inside the rectum and are typically painless but can cause bleeding. External haemorrhoids are under the skin around the anus and can be very painful when thrombosed (clotted). A prolapsed internal haemorrhoid is often mistaken for an external one because it appears outside the body, but it originates from inside the rectum.
The Four Grades of Haemorrhoid Severity
Doctors classify internal haemorrhoids according to grade to determine the best course of treatment:
1. Grade I: Haemorrhoids that bleed but do not prolapse.
2. Grade II: Haemorrhoids that prolapse during straining but retract spontaneously.
3. Grade III: Haemorrhoids that prolapse and require manual pushing back in.
4. Grade IV: Haemorrhoids that are prolapsed and cannot be manually reduced. This is the most severe stage and often requires medical intervention.
Top Signs and Symptoms You Shouldn't Ignore
Recognising the signs early can lead to quicker and more effective treatment.
Feeling a Bulge or Lump
The most telling sign of a prolapsed haemorrhoid is feeling a soft, often tender, lump or bulge of tissue at the anal opening. This lump may recede after a bowel movement or remain protruding.
Pain and Discomfort Levels
While internal haemorrhoids are usually painless, a prolapsed one can become painful if it gets irritated or its blood supply is cut off (strangulated). This can lead to a constant ache, sharp pain during sitting or bowel movements, and intense itching (pruritus ani).
Bleeding and Hygiene Concerns
Bright red blood on the toilet paper, in the toilet bowl, or coating the stool is a common symptom. The protruding tissue can also secrete mucus, leading to a feeling of dampness and difficulty with cleaning, which can further irritate the surrounding skin.
What Leads to a Prolapsed Haemorrhoid? The Root Causes
The development of prolapsed haemorrhoids is primarily linked to increased pressure in the lower rectum, which causes the vascular cushions to swell and stretch.
The Primary Culprit: Straining and Constipation
Chronic straining during bowel movements is the number one cause. This straining puts immense pressure on the veins in the rectal area. A low-fibre diet leads to hard stools and constipation, which exacerbates this straining.
Life Stages and Physical Strain
Several other factors can contribute to this increased pelvic pressure:
Pregnancy and Childbirth
The growing uterus presses on the veins in the pelvis, slowing blood return and causing haemorrhoids to enlarge. The intense straining of childbirth can also cause prolapse.
Ageing and Tissue Weakening
As we age, the supportive connective tissues in the rectum and anus can naturally weaken and stretch, making haemorrhoids more likely to prolapse.
Heavy Lifting and Occupational Risks
Jobs or activities that involve regular heavy lifting, prolonged sitting (especially on the toilet), or constant standing can increase abdominal pressure, contributing to haemorrhoid development and prolapse.
How Are Prolapsed Haemorrhoids Diagnosed?
If you suspect you have a prolapsed haemorrhoid, a doctor can provide a definitive diagnosis.
The Digital Rectal Exam (DRE)
A physician will typically begin with a visual inspection of the anal area and a digital rectal exam (DRE), where a gloved, lubricated finger is inserted into the rectum to feel for abnormalities.
When Further Investigation is Needed
To rule out other causes of rectal bleeding, like polyps or colitis, a doctor may recommend an anoscopy (using a short, lighted scope to view the anal canal) or a sigmoidoscopy/colonoscopy. If your condition requires diagnostic tests, Apollo24|7 offers convenient home collection for a variety of lab tests.
Finding Relief: Treatment Options from Home to Hospital
Treatment is tailored to the grade and severity of the haemorrhoids.
Grade 1 & 2: Home Remedies and Lifestyle Changes
For milder, reducible cases, conservative measures are highly effective.
The Power of Sitz Baths
Soaking the anal area in warm water for 15-20 minutes several times a day, especially after bowel movements, can reduce swelling, relieve pain, and improve blood flow.
Dietary Fibre and Hydration
Increasing fibre intake through fruits, vegetables, and whole grains softens stools, making them easier to pass and eliminating straining. Drinking plenty of water is essential for this to work.
Grade 3 & 4: Medical Procedures
When home care isn't enough, minimally invasive or surgical options are available.
Rubber Band Ligation
This common procedure for Grade II & III haemorrhoids involves placing a tiny rubber band around the base of the haemorrhoid, cutting off its blood supply. It withers and falls off within a week.
Hemorrhoidectomy
For large, persistent, or Grade IV haemorrhoids, a traditional surgical removal (hemorrhoidectomy) is the most effective and permanent solution, though it has a longer recovery time.
Can You Prevent Prolapsed Haemorrhoids?
Absolutely. Prevention focuses on reducing pressure and avoiding straining during bowel movements.
1. Eat a high-fibre diet (25-30 grams per day).
2. Stay hydrated (drink 8 glasses of water daily).
3. Exercise regularly to stimulate bowel function.
4. Avoid prolonged sitting on the toilet (don't take your phone in!).
5. Go when you feel the urge; don't delay bowel movements.
6. Practice proper lifting techniques (lift with your legs, not your back).
When is it Time to See a Doctor?
While many cases can be managed at home, seek medical advice if you experience:
1. Rectal bleeding that is persistent or heavy (you see a lot of blood).
2. Severe pain that isn't relieved by OTC treatments or sitz baths.
3. A prolapsed haemorrhoid that cannot be pushed back inside.
4. Symptoms that don't improve after a week of home care.
If your condition does not improve after trying these methods, book a physical visit to a doctor with Apollo24|7 for a comprehensive examination and to discuss the best treatment path for you.
Conclusion
A prolapsed haemorrhoid is an internal enlarged haemorrhoid that protrudes, or prolapses, through the anus. It is mainly caused due to constipation and recognised by the symptoms like bulge, pain, discomfort and bleeding. This condition can be diagnosed by digital rectal examination. The treatment includes sitz baths, hydration and inclusion of fibre in diet. Consult your doctor in sever conditions and for further guidance.
Consult a General Practitioner for Personalised Advice
Consult a General Practitioner for Personalised Advice
Dr Divya Lekha Gunta
General Practitioner
10 Years • MBBS, MD (Pathology)
Visakhapatnam
Apollo 24|7 Clinic - Andhra Pradesh, Visakhapatnam
Dr. Mohammed Kamran
General Practitioner
5 Years • MBBS, FIDM
Nashik
Apollo 24|7 Clinic - Maharashtra, Nashik
Dr Suseela
General Physician
5 Years • MBBS
Bengaluru
Apollo Medical Center, Marathahalli, Bengaluru
Dr. Rajib Ghose
General Practitioner
25 Years • MBBS
East Midnapore
VIVEKANANDA SEBA SADAN, East Midnapore
Dr. Shaik Abdul Kalam
General Practitioner
3 Years • MD (Physician)
Visakhapatnam
Apollo 24|7 Clinic - Andhra Pradesh, Visakhapatnam
(125+ Patients)
Consult a General Practitioner for Personalised Advice
Dr Divya Lekha Gunta
General Practitioner
10 Years • MBBS, MD (Pathology)
Visakhapatnam
Apollo 24|7 Clinic - Andhra Pradesh, Visakhapatnam
Dr. Mohammed Kamran
General Practitioner
5 Years • MBBS, FIDM
Nashik
Apollo 24|7 Clinic - Maharashtra, Nashik
Dr Suseela
General Physician
5 Years • MBBS
Bengaluru
Apollo Medical Center, Marathahalli, Bengaluru
Dr. Rajib Ghose
General Practitioner
25 Years • MBBS
East Midnapore
VIVEKANANDA SEBA SADAN, East Midnapore
Dr. Shaik Abdul Kalam
General Practitioner
3 Years • MD (Physician)
Visakhapatnam
Apollo 24|7 Clinic - Andhra Pradesh, Visakhapatnam
(125+ Patients)
Frequently Asked Questions
1. Can a prolapsed haemorrhoid go away on its own?
Grade II haemorrhoids that retract on their own may resolve with lifestyle changes. Grade III and IV haemorrhoids that remain prolapsed are unlikely to go away without medical treatment, as the stretched tissue cannot retract naturally.
2. Is it safe to push a prolapsed haemorrhoid back in?
Yes, for a Grade III haemorrhoid, it is generally safe and recommended. Gently push it back inside with a lubricated finger to reduce pain and irritation. If it is very painful or won't go back, do not force it and see a doctor.
3. Are prolapsed haemorrhoids a sign of cancer?
No, the symptoms of prolapsed haemorrhoids like bleeding, are not typically a sign of cancer. However, because colorectal cancer can also cause rectal bleeding, it is essential to get any bleeding properly diagnosed by a doctor to rule out more serious conditions.
4. What's the difference between a prolapsed haemorrhoid and an anal fissure?
Both can cause pain and bleeding. A haemorrhoid is a swollen vein, while a fissure is a small tear or cut in the lining of the anus. The pain from a fissure is often described as a sharp, tearing sensation during and after a bowel movement.
5. How long does it take to recover from rubber band ligation?
Most people experience a feeling of fullness or mild discomfort for 1-2 days. The banded haemorrhoid typically falls off within 7-10 days. You can usually return to normal activities the next day, but you should avoid heavy lifting for a short period.