Prolapsed Hemorrhoids Explained

What Are Prolapsed Hemorrhoids? 

Hemorrhoids are typically classified into different types based on their location within the anal canal. Internal hemorrhoids, which are located in the lining of the anal canal, tend to cause few noticeable symptoms in their early stages. However, when an internal hemorrhoid prolapses, the symptoms are more painful and visible.

Internal hemorrhoids are classified into four grades based on their severity and location. 

• Grade one hemorrhoids: This grade is the least severe. In this grade, the hemorrhoids do not protrude outside the anal canal during bowel movements.
• Grade two hemorrhoids: This grade is more advanced. Hemorrhoids will protrude during bowel movements but typically retract on their own. However, there may be discomfort or pain during stool passing.
• Grade three hemorrhoids: This grade is more severe. Hemorrhoids protrude during bowel movements but remain outside the anus unless pushed back manually. 
• Grade four hemorrhoids: This grade is the most advanced and severe form of internal hemorrhoids. They protrude outside the anus and will not remain inside even when pushed back manually. 

Prolapsed hemorrhoids, also known as prolapsed internal hemorrhoids, are an internal rectal disorder characterized by the protrusion or prolapse of one or more hemorrhoidal cushions. These hemorrhoids protrude outside the anus during bowel movements, causing discomfort and irritation. Prolapsed hemorrhoids are most common in individuals between the ages of 45 and 65.

Prolapsed Hemorrhoid Causes

There isn't yet any scientific consensus surrounding the reasons some people experience hemorrhoids while others do not. However, several factors are believed to contribute to the breakdown of muscular tissue in the lower intestines and the anal canal. 

Risk factors include the following conditions: 

• Being over the age of 45.
• Obesity.
• Sedentary lifestyle.
• Pregnancy.

Increased pressure within the anal veins, poor bowel habits, prolonged sitting on the toilet, and certain medical conditions are also contributing factors.

Prolapsed Hemorrhoids Symptoms

Although prolapsed hemorrhoids can be uncomfortable and painful, they are not generally considered a cause for concern unless they become severe or persist for an extended period. Complications from a severe prolapsed hemorrhoid include thrombosis, where a blood clot develops inside the hemorrhoid, and strangulation, which can cause tissue death.

The symptoms of prolapsed hemorrhoids include the following signs:

• Veins protruding from the anus: This is often the initial sign, as the enlarged veins become visible outside of the anus.
• Swelling and discomfort: The area surrounding the anus may feel swollen and sensitive, resulting in discomfort or pain.
• Itching and irritation: Prolapsed hemorrhoids may cause itching and irritation, particularly after passing stool.
• Bloody stools: In some cases, bleeding may occur during bowel movements, leading to stools that can be bright or dark red. 
• Painful bowel movements: Prolapsed hemorrhoids can be painful, especially during passing stools.
• Pressure or fullness: People with prolapsed hemorrhoids may experience a feeling of pressure or fullness in the anal region.

Prolapsed Hemorrhoid Treatment

The symptoms of prolapsed hemorrhoids in grades two and three can sometimes be managed using home care techniques. 

• Topical hydrocortisone ointments: Topical hydrocortisone ointments can help reduce inflammation and temporarily relieve prolapsed hemorrhoids. These ointments can be applied topically to the affected areas of the skin, soothing inflammation and promoting healing. Hydrocortisone ointments should not be used for longer than two weeks without consulting a healthcare professional.
• Sitz baths: Sitz baths are shallow warm water baths that can be applied to the affected areas of the anus. These baths can help reduce swelling, itching, and discomfort associated with grades one and two prolapsed hemorrhoids. 
• Moist towelettes: Moist towelettes can be used as an alternative to wet wipes or toilet paper to clean affected areas. Choosing towelettes specifically designed for sensitive skin is vital to avoid further irritation.
• Ice packs: Ice packs can mitigate the swelling and discomfort associated with prolapsed hemorrhoids. Applying ice packs around the affected areas can help reduce inflammation and numb the pain. Ice packs can be applied for 10-15 minute intervals with breaks in between. Using a towel-wrapped ice pack is essential to avoid direct skin contact.

In addition to using home care techniques, preventing hemorrhoids involves specific lifestyle adjustments, including managing constipation through a high-fiber diet, proper hydration, and getting plenty of exercise.

Advanced prolapsed hemorrhoids can be treated in several ways. Treatments for hemorrhoids include medical interventions such as hemorrhoidectomies, rubber band ligation, Doppler-guided hemorrhoid artery ligation, and hemorrhoid artery embolization (HAE).

• Hemorrhoidectomy: Hemorrhoid removal surgery is typically advised for prolapsed, grade 4 hemorrhoid relief. The intervention involves the surgical removal of the hemorrhoid using an electrocautery tool, laser, or scalpel. Hemorrhoidectomy is the most invasive treatment option, requiring closing sutures, wound care, and variable recovery times. 
• Rubber band ligation: This intervention is a procedure where elastic bands are placed around the base of the hemorrhoid to restrict its blood supply. This restriction causes the hemorrhoid to shrink and eventually fall off. 
• Doppler-guided hemorrhoid artery ligation: Doppler-guided hemorrhoidal ligation is a more precise technique involving using ultrasound to guide the insertion of rubber bands to target specific blood vessels.
• Hemorrhoid artery embolization (HAE): Embolization for hemorrhoids is a minimally invasive procedure involving injecting a clotting agent into the affected rectal artery, restricting blood supply to the hemorrhoid. 

The choice of procedure depends on the extent of the hemorrhoids, the patient's overall health, and personal preferences. 

Do I Have Rectal Prolapse or Hemorrhoids?

Hemorrhoids are networks of swollen veins located beneath the mucous membrane of the anus and lower rectum. They are a type of varicose vein that occurs explicitly in the anal canal or under the skin surrounding the anus.

Rectal prolapse, on the other hand, is a condition in which the muscles that hold the rectum in place weaken or deteriorate, causing the rectum itself to bulge from the anus.

Rectal Prolapse Causes

Several issues are believed to contribute to the development of rectal prolapse:

• Weakening of the muscles: Certain medical conditions, such as chronic constipation, childbirth injuries, or pelvic surgery, can cause the muscles around the rectum to weaken.
• Genetic predisposition: Some people might be genetically predisposed to develop rectal prolapse.
• Age and obesity: Older age and obesity can increase the risk of developing rectal prolapse due to the weakening of the muscles.
• Chronic straining: Engaging in chronic straining due to constipation, obesity, or certain physical activities can be a risk factor for rectal prolapse.
• Inflammatory bowel disease: People with inflammatory bowel disease, such as Crohn's disease or ulcerative colitis, are at a heightened risk of developing rectal prolapse.

Rectal Prolapse Symptoms

Symptoms of rectal prolapse are very similar to those of prolapsed hemorrhoids. The symptoms might include the following issues:

• Feeling as though something is coming out of the anus.
• A visible lump or bulge in the anus.
• Mucus or discharge from the anus.
• Itching, discomfort, or pain around the anus.
• Difficulty in passing stools or gas.
• Rectal bleeding or pain during bowel movements.
• Pain or discomfort within the lower abdominal area.

Rectal Prolapse Diagnosis and Treatment

Rectal prolapse is typically diagnosed through physical examination and diagnostic tests. The doctor may perform a rectal exam to assess the condition and evaluate any abnormalities. Additionally, imaging tests may be ordered to visualize the rectum and surrounding structures.

The treatment for rectal prolapse depends on the severity and the underlying cause. Non-surgical treatments, such as dietary modifications, stool softeners, or pelvic floor exercises, might be recommended initially. If these interventions fail, surgery may be necessary to repair the weakened tissues and stabilize the rectum.

Georgia Hemorrhoid Institute: Offering Minimally Invasive Prolapsed Hemorrhoid Treatment

Georgia Hemorrhoid Institute’s hemorrhoid doctors in Atlanta specialize in the targeted and effective treatment of hemorrhoids. Our team of medical professionals is committed to providing exceptional and patient-centered endovascular care for people struggling with symptomatic hemorrhoids.

We recognize the importance of addressing hemorrhoid symptoms promptly and effectively. Our medical team is dedicated to staying current with the latest advancements in hemorrhoid treatment, ensuring our patients receive the best possible care. 

Our healthcare professional team has extensive experience treating hemorrhoids using advanced techniques like hemorrhoid artery embolization (HAE). This expertise provides patients with the highest level of care and a tailored treatment plan that meets their individual needs and expectations.

Don't wait to find relief from prolapsed hemorrhoids. Contact the caring team at Georgia Hemorrhoid Institute today.