Prolapsed haemorrhoids occur when either an external or internal haemorrhoid swells to the point that it comes outside of the anus. An internal haemorrhoid occurs when the veins of the rectum become irritated due to excess pressure on them and is usually completely painless. An external haemorrhoid occurs when the veins of the anus become irritated due to excess pressure. The rectum is the canal that connects the colon to the anus, where faeces exit the body.
An internal haemorrhoid is considered a prolapsed haemorrhoid when it bulges outside of the anus and is now external. What makes a prolapsed haemorrhoid different from an external haemorrhoid is that a prolapsed haemorrhoid forms inside of the body. External haemorrhoids can also prolapse, causing the haemorrhoid that formed around the anus to bulge out to another area of the bottom.
It’s important to understand that prolapse is caused by a weakening of the tissue that holds the haemorrhoid in place, so when an external haemorrhoid prolapses, it may move ever so slightly. However, that move can be very painful.
Prolapsed haemorrhoids can be uncomfortable or even painful. They can also be accompanied by itching around the anus, small bumps around the anus, bleeding bright red blood, pain when trying to pass a bowel movement, and the feeling of still needing to pass a bowel movement.
Haemorrhoids usually prolapse due to increased pressure on the veins in the rectum or anus due to a number of reasons, including:
As the pressure on the veins in the rectum or anus increases, the connective tissue holding the haemorrhoid in place weakens, contributing to the ability of the haemorrhoid to move.
The main risk factor for haemorrhoids is age. The likelihood of developing haemorrhoids increases as you get older.
A doctor should be able to visualise a prolapsed haemorrhoid during a physical exam of the anus. In some cases, you will be able to gently push an internal prolapsed haemorrhoid back up into the rectum. If you have done this before seeing a doctor, they may perform a digital rectal exam on you. During a digital rectal exam, a doctor will put a lubricated, gloved finger in the rectum to feel any haemorrhoids for severity and size. They can also push any internal prolapsed haemorrhoid back into the rectum for your comfort.
A physical examination and a medical history will allow a doctor to make a definitive diagnosis.
Complications of prolapsed haemorrhoids can include:
Prolapsed haemorrhoids may resolve on their own with the help of some at-home treatments, including incorporation of high-fibre foods into the diet, soaking in warm baths, using topical haemorrhoid cream, and taking over the counter pain medication.
However, if pain or other symptoms last, prolapsed haemorrhoids may require further treatment. Minimally invasive treatments include use of chemicals, infrared light, and heat to shrink the haemorrhoid, as well as use of tiny rubber bands to kill it so it falls off. Surgery is also a very effective option.