Internal Hemorrhoid Protrusion (Prolapsed Hemorrhoid)

Hemorrhoids are enlarged, swollen veins that form in the rectum or anus. External hemorrhoids form under the skin along the anal canal and don’t change positions. Internal hemorrhoids are in the rectum, and they can slip outside of the anus, forming a bulge or protrusion. When this happens, it is referred to as a prolapsed hemorrhoid.

An internal hemorrhoid that prolapses can be very painful, and when left untreated, it can get worse until it develops into thrombosis, strangulation, an infection, or becomes permanently prolapsed. 

Treatment for a prolapsed hemorrhoid depends on how severe the protrusion is, the size, and the severity of symptoms. Understanding why hemorrhoid protrusion happens and what to do about it can help you avoid serious complications and get lasting relief. 

Signs and Symptoms of Prolapsed Hemorrhoids

Prolapsed hemorrhoids are detectable outside of the anus. They feel like soft lumps of tissue and can be visible outside the body.

If you have a prolapsed hemorrhoid, you might notice a soft lump — or several lumps — bulging out from the anus. Other symptoms associated with a prolapsed hemorrhoid include discomfort, pain, and pressure during a bowel movement. It might feel like you still need to use the bathroom after passing a stool.

Identifying Prolapsed Hemorrhoids

There might also be common symptoms of internal hemorrhoids, such as the following:

  • Bright red blood in the stool or on toilet paper
  • Mucus in the stool
  • Itchiness around the anus
  • Noticeable lump outside/around the anus
  • Discomfort or irritation near the anus 
  • Anal swelling 

If you notice signs of a prolapsed hemorrhoid, it’s important to see a doctor for an evaluation. USA Hemorrhoid Centers offers non-surgical prolapsed hemorrhoid treatment, helping relieve symptoms.

Stages of Prolapsed Hemorrhoids

Internal hemorrhoids are graded based on how much they protrude. The hemorrhoid grading system doctors use to diagnose and treat internal hemorrhoids has four stages—the more severe the symptoms, the higher the grade or stage. 

  • Grade 1: The hemorrhoids might prolapse into the anal canal, but they don’t protrude outside of the anus. A first-degree hemorrhoid can cause typical internal hemorrhoid symptoms and pressure.
  • Grade 2: The hemorrhoid protrudes when straining, usually during a bowel movement. But then it retracts to its previous position on its own. 
  • Grade 3: The hemorrhoid won’t return to its original position unless pushed back inside. 
  • Grade 4: The protrusion is permanent. These hemorrhoids can’t be pushed back inside and are very painful.

What Causes Hemorrhoid Protrusion?

Hemorrhoids prolapse because of increased pressure in the rectal or anal area or weakened tissue. 

Increased pressure from straining can cause the hemorrhoid tissue to swell and enlarge so much that the hemorrhoid protrudes. Constipation can cause this extra straining during a bowel movement. When the stool is hard, the anus can’t open and close properly. As a result, more straining is required to pass the stool. A lack of lubrication due to a hard stool can also cause the hemorrhoid to become more enlarged, leading to prolapse. 

Weaker tissue can also be the cause of hemorrhoid protrusion. Tissue in the anal or rectal area can weaken due to age, injury, or childbirth. Weaker tissue is more likely to swell and become large enough to slip into the anal canal and bulge outside of the anus. 

Treatment for Prolapsed Hemorrhoids

The best treatment for prolapsing hemorrhoids depends on their grading, symptoms, and size. A first-degree hemorrhoid might respond well to conservative treatment methods, including at-home care and lifestyle changes, such as the following:

  • Sitz baths to relieve pain and discomfort
  • Stool softeners to reduce constipation and prevent straining
  • Adding fiber to the diet and drinking more water to prevent constipation
  • Hemorrhoid creams to relieve itching and irritation

Hemorrhoids that are stage 1 or 2 and some cases of grade 3 hemorrhoids can be treated with non-surgical procedures.

  • Hemorrhoid artery embolization (HAE) is a less invasive alternative to surgery with minimal complications. HAE is a pain-free procedure that allows patients to recover faster. It also leaves the hemorrhoid tissue in place and doesn’t create rectal wounds. 
  • Infrared coagulation is a minimally invasive procedure for hemorrhoids that uses heat energy to shrink the hemorrhoid tissue.
  • Sclerotherapy injections help to stop the flow of blood to hemorrhoid tissue, causing them to shrink. 
  • Rubber band ligation involves tying off the hemorrhoids with a rubber band so they shrink and fall off. 

Some grade 3 hemorrhoids and grade 4 hemorrhoids might require hemorrhoid removal surgery. A hemorrhoidectomy can cause complications, such as continence issues and pain, so it’s usually only recommended for hemorrhoids that don’t respond to other, less invasive treatments. 

When to Seek Medical Attention

It’s important to see a hemorrhoid doctor if you have symptoms of prolapsed hemorrhoids that last for more than a few days. Patients with early-stage hemorrhoids have more treatment options, and the hemorrhoids are less likely to reoccur when treated early. 


USA Hemorrhoid Centers is the expert in non-surgical hemorrhoid care. We offer hemorrhoid artery embolization (HAE) and treat our patients in our outpatient hemorrhoid clinics. Our hemorrhoid doctors will take the time to determine if HAE is right for you and create a personalized treatment plan to help you get relief.

FAQs about Prolapsed Hemorrhoids

Can a prolapsed hemorrhoid heal on its own?

A mild prolapsed hemorrhoid might heal on its own with lifestyle changes, like adding fiber to the diet and drinking more water to prevent constipation and straining during a bowel movement. However, prolapsed hemorrhoids can also get worse if left untreated, leading to more severe symptoms, including pain and persistent blood loss, and anal itching

If you notice hemorrhoid symptoms for more than one week, schedule a consultation with a hemorrhoid doctor to find out what treatment can help you get relief. 

How long does a prolapsed hemorrhoid last​?

A prolapsed hemorrhoid can last for a few days. However, it can also persist for weeks or months, so seeking medical care early on is important. If it worsens and doesn’t move back to its position after being pushed inside, it won’t go away without treatment. 

What is the difference between hemorrhoid prolapse and rectal prolapse?

A prolapsed hemorrhoid is an internal hemorrhoid (swollen veins and connective tissue that forms in the rectum) that slips into the anal canal and can protrude outside of the anus. Rectal prolapse is when rectal tissue comes out of the anal canal.

Rectal prolapse can happen if the tissue is weak and there is a lot of straining. It can also occur along with a prolapsed hemorrhoid, with both the hemorrhoid and some rectal tissue coming outside of the anus. 

Google Rating:
5/5

I am so glad to have gone to USA Hemorrhoid Centers. My experience has been amazing. The staff are all so friendly but professional. The doctor is wonderful and in his professional manner makes you very comfortable and explains anything you have questions about. So very happy.

USA Hemorrhoid Centers testimonial

Abe K.

Google Rating:
5/5

USA Hemorrhoid Centers all staff were incredible. They communicated throughout and checked in frequently to ensure I was as comfortable as possible. I am happy I chose to get the treatments and look forward to the improvements.

USA Hemorrhoid Centers Patient

Alexis B.

Google Rating:
5/5

I am so glad to have gone to USA Hemorrhoid Centers. My experience has been amazing. The staff are all so friendly but professional. The doctor is wonderful and in his professional manner makes you very comfortable and explains anything you have questions about. So very happy.

USA Hemorrhoid Centers testimonial

Abe K.

Google Rating:
5/5

USA Hemorrhoid Centers all staff were incredible. They communicated throughout and checked in frequently to ensure I was as comfortable as possible. I am happy I chose to get the treatments and look forward to the improvements.

USA Hemorrhoid Centers Patient

Alexis B.


Schedule Anytime, Anywhere

Skip the wait times! Scheduling at your fingertips, 24/7. Our doctors who perform Hemorrhoid artery embolization are experienced interventional radiologists with expertise in vascular anatomy.