What Is Hemorrhoidal Prolapse and How Is It Treated?

The pain. The itching. The burning. If you have hemorrhoids, you’re probably familiar with all of those symptoms. And you have a lot of company — about one of every 20 Americans has hemorrhoids, with prevalence increasing as you get older.

As a leading medical provider in San Clemente, California, Elvira Klause, MD, treats hemorrhoids, helping patients feel more comfortable and avoid more serious complications. Hemorrhoidal prolapse is a relatively common complication associated with internal hemorrhoids — and one you should know about if you’re plagued by hemorrhoid symptoms.

Why hemorrhoids happen

Hemorrhoids are swollen veins in or near your rectum. Several factors can increase the likelihood that you’ll develop hemorrhoids, including:

• Chronic constipation
• Chronic diarrhea
• Straining a lot during bowel movements
• Spending a lot of time sitting on a toilet
• Eating a diet low in fiber
• Pregnancy
• Obesity
• Standing or sitting for long periods
• Repetitive heavy lifting

Women are more likely to have hemorrhoids, and they’re also more common among people over age 50.

Internal vs. external hemorrhoids

Hemorrhoids can be either internal or external depending on where they form. Hemorrhoids located inside your rectum are internal, while those that form near the outside of your anus are external hemorrhoids.

External hemorrhoids typically feel like bumps or lumps near your anus, and they’re more likely to cause pain, itching, and burning. They’re also more likely to bleed when you have a bowel movement.

Internal hemorrhoids can bleed a bit if you’re constipated or pass a hard stool. But frequently, they cause no symptoms unless they prolapse, or push outward. 

Prolapsed hemorrhoids vs. external hemorrhoids

The main difference between a prolapsed internal hemorrhoid and an external hemorrhoid is simple: External hemorrhoids form on the outside of your anus, while a prolapsed hemorrhoid forms internally and extends outside the anus.

Internal hemorrhoids usually prolapse because of increased pressure on the rectum due to any of the risk factors listed above. When pressure increases, the vessels that comprise your hemorrhoids tend to swell and drop, pushing out of the anal sphincter.

Complications

If a prolapsed hemorrhoid swells, it can wind up blocking your anus and obstructing your bowel, preventing you from having bowel movements. Some prolapsed hemorrhoids bleed heavily, increasing the risk of life-threatening blood loss.

Prolapsed hemorrhoids are also more likely to form dangerous clots (thrombosis) or become strangulated, resulting in circulation problems that can lead to tissue death. For these reasons, it’s very important to seek medical care for hemorrhoids — even if they’re not prolapsed.

Find relief for symptomatic hemorrhoids

Dr. Klause offers several solutions for symptomatic hemorrhoids that don’t respond to over-the-counter ointments and other conservative options. These include:

• Rubber band ligation 
• Sclerotherapy injections
• Transanal hemorrhoidal dearterialization

These methods block circulation to the hemorrhoids, and they eventually die. In more severe cases, Dr. Klause suggests hemorrhoidectomy, a surgical procedure that removes hemorrhoid tissue.

If you have hemorrhoids, scheduling an evaluation with Dr. Klause is the best way to find relief from pain and other symptoms — and to prevent more serious problems from happening. To schedule your evaluation, call 949-393-2595 or book an appointment online today.