Home Hemorrhoids Hemorrhoid vs Rectal Prolapse: 9 Symptoms & Treatments [Covered]

Hemorrhoid vs Rectal Prolapse: 9 Symptoms & Treatments [Covered]

The Difference Between Hemorrhoids and Rectal Prolapse
Our recommended Product - Dr. Numb® 5% Lidocaine Cream - 30g

Hemorrhoids and rectal prolapse are common health issues that can cause discomfort and embarrassment. While both conditions affect the anal area, they have different causes, symptoms, and treatment options.

A key difference between a rectal prolapse and an internal hemorrhoid is in the orientation of the mucosal folds. While rectal prolapse typically presents with circular folds (A, B), internal hemorrhoids exhibit radial folds (C).

This blog post will explore the similarities and differences between hemorrhoids and rectal prolapse and their causes, symptoms, and diagnostic methods. We'll also discuss pelvic floor physical therapy for managing these conditions, as well as conservative and surgical treatment options.

Hemorrhoid vs. Rectal Prolapse

One must survey their symptoms, causes, and treatments to distinguish between hemorrhoids and rectal prolapse.

A comprehensive evaluation is necessary to arrive at a correct diagnosis, and only then can an effective treatment plan be put in place.

Rectal Prolapse and Hemorrhoids Symptoms

Rectal bleeding is a common symptom associated with these conditions. However, differences exist in its severity, frequency, and appearance, which can aid in distinguishing between them.

Other key symptoms include difficulties with bladder control, the need for manual reinsertion in rectal prolapse, and various types of pain in the anal region.

Rectal Bleeding

Hemorrhoids and rectal prolapse can cause bleeding from the rectum, but the severity and frequency of bleeding typically differ between the two conditions. Hemorrhoids often cause light to moderate bleeding with bowel movements, while rectal prolapse may cause more severe and frequent bleeding.

The appearance of blood can also differ between hemorrhoids and rectal prolapse. Hemorrhoidal bleeding is typically bright red, whereas bleeding from rectal prolapse may be darker and mixed with stool.

Incontinence Difficulties

Problems with incontinence and rectal prolapse

Incontinence difficulties are more commonly associated with rectal prolapse than hemorrhoids. Controlling bowel movements and keeping a stool inside the rectum can be difficult with rectal prolapse.

Manual reinsertion of the prolapsed tissue may sometimes be necessary to regain bowel control. Hemorrhoids‌ are not typically associated with incontinence.

Pain or Discomfort in the Anal Area

There can be discomfort in the anal region, but the type of pain differs between the two conditions.

Hemorrhoids can cause uncomfortable burning or itching, and rectal prolapse can cause severe pain while straining during bowel movements.

Hemorrhoids ‌cause discomfort during or after bowel movements, whereas rectal prolapse discomfort can last longer.

Don't Let Hemorrhoids Hold You Back
Say goodbye to discomfort, find quick relief with our 5% lidocaine hemorrhoid cream.

Excessive Straining

Excessive straining during bowel movements is more familiar with rectal prolapse than hemorrhoids. With rectal prolapse, the rectal tissue protrudes from the anus and can cause difficulty passing the stool.

This can lead to increased straining and pressure on the rectum, making the condition more painful. Hemorrhoids can also cause straining during bowel movements, typically less severe.

Abdominal Discomfort

Abdominal discomfort is often associated with rectal prolapse and is less common with hemorrhoids. The pressure and irritation caused by the prolapse of rectal tissue can lead to pain in the lower abdomen. Hemorrhoids may cause some discomfort in the anal area, but they are typically localized to that region and do not extend to the stomach.

Incomplete Bowel Movements

Hemorrhoid or a rectal prolapse may lead to incomplete bowel movements, but the underlying causes differ. With hemorrhoids, incomplete bowel movements are often due to pain or discomfort, while rectal prolapse is due to the prolapsed tissue blocking stool from passing through the rectum..

Anal Itching

Hemorrhoids and Rectal Prolapse Symptoms Anal Itching

Anal itching is a common symptom of hemorrhoids and can also occur with rectal prolapse. Hemorrhoids can cause itching due to excessive moisture and irritation in the anal area, while rectal prolapse may lead to itching due to the prolapsed tissue rubbing against the skin.

Lumps Around the Anus

Lumps around the anus are a common symptom of both hemorrhoids and rectal prolapse, but the characteristics of the lumps can differ between the two conditions.

Hemorrhoids typically cause soft, swollen bumps around the anus, while rectal prolapse can cause harder and more tender lumps that protrude from the anus. In addition, the size and shape of the lumps can vary between hemorrhoids and rectal prolapse.

Severe Pain

Severe pain is associated with rectal prolapse rather than hemorrhoids. The pressure and trauma caused by the prolapsed tissue can lead to intense pain, especially during bowel movements. Hemorrhoids can cause discomfort and pain but are typically less severe and localized to the anal area.

Hemorrhoids vs. Rectal Prolapse: Causes

Hemorrhoids and rectal prolapse commonly cause discomfort and pain in the rectal area. While these conditions share similar symptoms, such as bleeding and itching, their underlying causes and treatments vary greatly. Find a detailed comparison in the table below.

Causes Hemorrhoids Rectal prolapse
Straining during bowel movements Yes No
Pregnancy and childbirth Yes No
Aging Yes No
Weakened pelvic floor muscles No Yes
Chronic diarrhea or constipation No Yes
Nerve damage No Yes
Prolonged sitting or standing Yes No
Being overweight Yes No
Family history Yes No
Pelvic surgery or radiation therapy No Yes

Please note that this table provides a general overview and may not include all possible causes for each condition. Consulting a healthcare professional for a thorough evaluation and diagnosis is essential.

Don't Let Hemorrhoids Hold You Back
Say goodbye to discomfort, find quick relief with our 5% lidocaine hemorrhoid cream.

Differences in the Advanced Stages of Rectal Prolapse vs. Hemorrhoids

Hemorrhoids and rectal prolapse are two common conditions affecting the rectal area. Although they may share similar symptoms, they are two distinct conditions requiring different treatment forms.

Understanding the differences between advanced stages of hemorrhoids and rectal prolapse is essential to diagnose accurately and choose the appropriate treatment for patients.

Distinguishing by Prolapse of Hemorrhoids and Rectal Prolapse

Hemorrhoids are swollen veins that can develop inside or outside the anal canal. In some cases, they can prolapse or bulge outside the anus, causing discomfort, pain, and itching. It's important to note, however, that hemorrhoids generally do not extend beyond the anal sphincter.

Rectal prolapse is when the rectum protrudes through the anus, causing discomfort. In advanced stages, it can involve the total thickness of the rectal wall, leading to a horseshoe-shaped protrusion. Many patients incur pain while sitting or standing, along with fecal incontinence.

Distinguishing by Bleeding When Defecating

Bleeding is similar to hemorrhoids and rectal prolapse in symptoms. However, there are differences in the amount and frequency of bleeding. Hemorrhoids typically cause bright red bleeding during bowel movements due to the engorged vessels.

In contrast, rectal prolapse can cause darker, burgundy-colored bleeding due to the friction and trauma that occurs during prolapse.

Diagnosing Rectal Prolapse vs. Diagnosing Hemorrhoids

There are many conditions affecting the anus and rectum. They can cause discomfort, pain, and bleeding during bowel movements. However, they are different issues that require other treatments. Therefore, it is essential to understand their differences and know the available treatments to provide proper care. A correct diagnosis is also crucial to determining the best course of treatment.

Methods of diagnosis for both conditions

Hemorrhoids and Rectal Prolapse in Advanced Stages Methods of Diagnosis

There are several ways to diagnose hemorrhoids and rectal prolapse, such as:

  • Physical Examination: A physician can perform a physical examination to help diagnose both hemorrhoids and rectal prolapse. In the case of hemorrhoids, the doctor will check for swelling or lumps around the anus and signs of bleeding. For rectal prolapse, the doctor will look for a protruding ring of tissue around the anus or the rectal mucosa hanging out of the anus.
  • Colonoscopy or Sigmoidoscopy: A colonoscopy or sigmoidoscopy may be performed if the doctor detects bleeding or other abnormalities during the physical examination. These procedures involve using a flexible, lighted tube with a camera to examine the inside of the rectum and colon. In the case of rectal prolapse, this may show the extent of the prolapse and whether surgery is necessary to correct it.
  • Anorectal Manometry: This test measures the strength and coordination of the muscles that control bowel movements. It detects hemorrhoids and rectal prolapse, as weakened anal sphincter muscles can cause these conditions. Anorectal manometry is done by inserting a thin tube with a balloon into the rectum and measuring pressure changes during muscle contractions.
Don't Let Hemorrhoids Hold You Back
Say goodbye to discomfort, find quick relief with our 5% lidocaine hemorrhoid cream.

Differential Diagnosis Between the Two Conditions

Hemorrhoids occur when the veins in the anal canal become swollen, while rectal prolapse happens when the rectum protrudes outside the anus. While both conditions can be uncomfortable and should be examined by a physician, they are distinct issues that require different treatments.

Some factors that distinguish hemorrhoids from rectal prolapse are:

  • Causes: most times, hemorrhoids are caused by straining during bowel movements, pregnancy, or obesity. Rectal prolapse is typically caused by weakened anal sphincter muscles, which can be because of aging, chronic constipation, or nerve damage.
  • Symptoms: Hemorrhoids often cause itching, bleeding, and pain during bowel movements, whereas rectal prolapse may cause a feeling of fullness or something falling out of the anus.
  • Treatments: Hemorrhoids can usually be treated with over-the-counter remedies or prescription medications and, in severe cases, surgery. Rectal prolapse may require surgery to correct, although sometimes, it can be managed with exercises to strengthen the pelvic floor muscles.

Treatment of Rectal Prolapse vs. Hemorrhoids

Comparing treatment of rectal prolapse and hemorrhoids

Rectal prolapse and hemorrhoids are two distinct conditions that affect the rectal area. The treatment for each may vary depending on its severity and underlying causes.

Conservative Treatment Options

The symptoms of hemorrhoids and rectal prolapse are distinct conditions that may share similar symptoms, such as rectal bleeding and discomfort. Conservative treatments for these conditions include dietary changes, increased physical activity, and topical treatments.

Dietary Changes

Hemorrhoids and rectal prolapse can be managed with dietary adjustments. Encourage patients to increase fiber intake to promote smooth bowel movements, prevent constipation, and avoid these conditions.

Don't Let Hemorrhoids Hold You Back
Say goodbye to discomfort, find quick relief with our 5% lidocaine hemorrhoid cream.
Increased Physical Activity

Increasing physical activity can help reduce the pressure on the rectum and anus, which can help prevent hemorrhoids and rectal prolapse.

Patients should be advised to engage in moderate exercise, such as brisk walking or cycling, for at least 30 minutes daily to help alleviate symptoms.

Topical Treatments

Various topical treatments are available for managing hemorrhoids and rectal prolapse. These treatments can help reduce inflammation, swelling, and pain. Topical treatments may include local anesthetics, steroid creams, and over-the-counter medications such as witch hazel.

Surgical Treatment Options for Hemorrhoids and Rectal Prolapse

Surgical treatments include hemorrhoidectomy for large or prolapsing hemorrhoids and prolapse surgery, such as rectopexy and rectum resection. Treatment decisions should be made in consultation with a healthcare professional based on symptom severity, patient preference, and comorbidities.


Prolapse Treatment from Hemorrhoids Hemorrhoidectomy

Hemorrhoidectomy is a surgical procedure that involves the removal of hemorrhoids. This procedure is usually reserved for large or prolapsing hemorrhoids that do not respond to conservative treatments.

Procedures to Repair or Remove Prolapsed Tissue

There are various surgical options available for the treatment of rectal prolapse. These procedures may involve repairing or removing the prolapsed tissue. The most common methods include rectopexy and resection of the rectum.

It is important to note that the choice of treatment for hemorrhoids and rectal prolapse depends on various factors, including symptoms' severity, patient preference, and comorbidities. Patients should seek medical advice from a healthcare professional before starting any treatment.

Physiotherapy for Rectal Prolapse and Hemorrhoids

Pelvic floor physical therapy can be an effective non-invasive treatment option for rectal prolapse and hemorrhoids. This approach focuses on strengthening the muscles in the pelvic floor to improve bowel function and reduce symptoms.

Explanation of Pelvic Floor Physical Therapy

Pelvic floor physical therapy is a specialized form of physical therapy that targets the muscles, ligaments, and connective tissues that support the pelvic organs, including the bladder, uterus, and rectum. Pelvic floor physical therapy aims to help patients improve their bowel function and reduce symptoms associated with rectal prolapse and hemorrhoids.

Don't Let Hemorrhoids Hold You Back
Say goodbye to discomfort, find quick relief with our 5% lidocaine hemorrhoid cream.

Pelvic Floor Physical Therapy for Rectal Prolapse and Hemorrhoids

Pelvic floor physical therapy benefits patients with rectal prolapse and hemorrhoids. It is a non-invasive treatment option that does not require surgery and can effectively reduce symptoms. Pelvic floor physical therapy can also help patients avoid needing medications or other more invasive treatments. In addition, pelvic floor physical therapy can improve overall pelvic health and reduce the risk of future complications.


Understanding rectal prolapse and hemorrhoids is crucial for getting a proper diagnosis and treatment. They may share symptoms like rectal bleeding and pain, hemorrhoids, and rectal prolapse but have distinct characteristics requiring different medical interventions.

Dietary changes, exercise, and topical medications may alleviate symptoms in mild cases, but serious issues might need surgical intervention. In mild cases, nutritional changes, training, and topical drugs may help symptoms, but severe cases might need surgical intervention.

Don't hesitate to talk to your healthcare provider if you experience any of these symptoms or suspect you have hemorrhoids or rectal prolapse.

Our recommended Product - Dr. Numb® 5% Lidocaine Cream - 30g
Matt Callard
I am a passionate traveler, as if traveling were my full-time job. I like to change my surroundings and environment, like changing desktop wallpaper. Nature increases the concentration in my writing, which helps brainstorming flow in my blood. I have a cat named Kitana. She is the most desperate about traveling, more than any other cat. How do I know? If I miss any tour in any week, she literally destroys my clothing with her wolverine nails.

I and my cat also participate in extreme activities like surfing, biking, hill tracking, paragliding, boating, etc. She was always there in my accidents, injuries, and stitches. She always sits on my lap when it hurts me most. The funniest part is that she has experienced all my tattoos. She sleeps on my blanket when I go through any painful experience.

My hobbies and lifestyle added many pain and injuries to my life. That is why I have a lot of experience in dealing with different levels of pain and burn. It influenced me to become a pain expert and share primary suggestions to handle any unwanted situations that hurt.


  • What are the potential complications of hemorrhoid surgery that may result in rectal prolapse?

    Hemorrhoid surgery, also known as hemorrhoidectomy. While it is generally a safe and effective treatment option, potential complications, including rectal prolapse, can arise.

    Rectal prolapse occurs when the rectum protrudes or falls through the anal opening. One of the factors contributing to this condition is hemorrhoid surgery. A surgical procedure eliminates hemorrhoids by removing or tying off the hemorrhoidal tissue, which can be internal or external. Sometimes, the surgery may weaken the muscles and tissues supporting the rectum, causing rectal prolapse.

    Hemorrhoid surgery can lead to rectal prolapse, depending on the extent of surgery, the patient's overall health, and the surgeon's technique. Much hemorrhoidal tissue is usually removed during extensive or complicated surgical procedures. Hemorrhoidal tissue is often removed during extensive or complicated surgeries.

    After hemorrhoid surgery, rectal prolapse is a potential complication and not a common occurrence. The majority of patients recover without experiencing this complication. Before undergoing surgery, you should discuss this possibility with your healthcare provider.

  • Can external hemorrhoids become prolapsed?

    Hemorrhoids are swollen blood vessels under the skin around the anus. External hemorrhoids can cause significant discomfort, but they rarely prolapse. In prolapse, an organ extends or falls from its normal position. Hemorrhoids commonly prolapse with internal hemorrhoids.

    Anal hemorrhoids can sometimes extend or prolapse from the rectum. This can happen during bowel movements or straining and may result in a range of symptoms, including bleeding, pain, and a feeling of fullness or incomplete bowel movements.

    External hemorrhoids are less likely to prolapse. The lumps or bumps are usually visible as swollen lumps outside the anus. However, outside of the internal hemorrhoids, external hemorrhoids can still cause discomfort and may require appropriate treatment.

    Suppose you are experiencing concerns about external hemorrhoids, such as persistent pain or bleeding. In that case, it is advisable to consult a healthcare professional for a proper diagnosis and appropriate treatment options.

  • What are the signs of a prolapsed internal hemorrhoid?

    Prolapsed internal hemorrhoids include a visible or palpable bulge protruding from the anus, discomfort or pain, bleeding, and a feeling of incomplete bowel movements.

Back to blog
More Content