Hemorrhoids, a condition where the rectal and anal veins weaken and distend because of impaired venous blood flow, can cause one or more layers of the rectum to protrude or stick out through the anus. This condition is termed a prolapse. Although the occurrence of this condition and hemorrhoids does not occur frequently, the protrusion of the rectum necessitates a physician consultation. Prolapse associated with hemorrhoid development usually occurs in cases of prolonged rectal and anal venous swelling. Moreover, it was found that the incidence of rectal prolapse is higher in larger internal hemorrhoids.

One kind of lump – you could deal with it. But having two types of lumps? That’s a different story! There is nothing more distressing and embarrassing than to find more than one lump or swelling sticking out of your anus. Moreover, since both conditions can occur in the same area, how can you possibly know which is which? In the succeeding parts, prolapse is further discussed to give you a clearer idea about this condition.

Rectal prolapse, as mentioned, is the protrusion of the rectum wall outside the anus. In this condition, one portion of the rectum telescopes into its immediate adjacent segment, the anus.

The exact cause of prolapse is not completely understood. It is likely that the prolapse is a multifactorial disease, meaning, it is brought about by the interplay of many causes. It is associated with:

• pinworm and whipworm infections
• malnutrition
• malabsorption
• cystic fibrosis
• anal trauma
• constipation

Prolapse is manifested by rectum protrusion during walking or moving a bowel. A sensation of rectal fullness is also commonly reported with a feeling of incomplete bowel evacuation and rectal incontinence.

Prolapse commonly coexists with hemorrhoids – the hemorrhoids do not cause the protrusion of the rectum.

One possible explanation for their coexistence is that both conditions are associated to constant straining that could cause the weakening of the muscles that support the positioning of the rectum. Though they have the same signs and symptoms, they are two separate medical conditions. Prolapse affects a segment of the large intestine above the anus, whereas, hemorrhoids occur in the area near the anal ring. The diagnosis of rectal prolapse is determined by the medical history, manifestations and visual examination of the rectum.

In normal anatomy, the rectum is the located in the latter portion of the large intestine. More specifically, it is located above the anal canal. Through the muscles and ligaments, the rectum is securely fixed and properly positioned. But it in cases where the muscles and ligaments weaken, the rectum’s attachment to the body is also compromised.

During its early stage, the rectum is still attached to the body, but because the connection is not strong as before, the inner lining of the rectum mucosa protrudes from the anus. As the rectum mucosa gets more prolapsed, the ligaments and muscles continue to weaken, which subsequently result in the protrusion of the entire wall of the rectum.

If you have a hemorrhoid with concurrent rectal prolapse, it’s a little assuring to know that complete prolapse of the rectum rarely occurs in hemorrhoids.

You can differentiate what type of hemorrhoid you have by knowing their location, description and the symptoms they produce. There are two types of hemorrhoids namely, internal and external hemorrhoids.

Internal hemorrhoids are hemorrhoids that are located inside the anus. They may lie far up inside the rectum, around 2 to 4 cm above the opening of the rectum so that you cannot see or feel them. They are usually painless due to few pain-sensing nerves in that location. This is also indicative that what you have is not severe.

Not so severe hemorrhoids may range from painless to producing mild discomfort, most especially when the stool accidentally brushes off with your hemorrhoid while defecating.

Usually, bleeding is the only sign that they do exist. Then, when you see a streak of bright red blood on the surface of your stool after defecating, you should suspect that you have internal piles, and that an appropriate consultation should be made.

Aside from bleeding, other signs of internal piles are itching and burning sensation of the anus and rectum. There is also the feeling of a need to defecate even after just finishing a round of painstaking bowel movement.

Internal hemorrhoids often are small swollen veins in the wall of the anal canal. They usually occur when the tissues supporting the veins in the anal canal weaken and get swollen, as tissues bulge into the anal canal.

These kinds of hemorrhoids can also be large, sagging veins that bulge out of the anus. When they protrude outside the anus, they can become very painful and irritated, most especially when squeezed by the anal muscles, most especially during the course of elimination.

When they protrude or get prolapsed , they are sometimes difficult to distinguish from external hemorrhoids. If the pain becomes severe, it may indicate that the blood supply to the hemorrhoids is severely reduced by the sphincter muscle of the anus, or worse has been totally cut off. At this point in time you can say that your hemorrhoids have gone bad! If this is the case, emergency treatment is highly recommended.

For treatment purposes, internal piles are graded according to their size and severity:

• Grade 1 shows a small swelling and located high up the anus. This is the common type and may enlarge further to grade 2 or higher
• Grade 2 is a hemorrhoid larger than grade 1. It may partly protrude the anus when you poop, but quickly ‘springs back’ inside again.
• Grade 3 protrudes from the anus, but can still be pushed back inside the anus with your finger.
• Grade 4 is often quite large and permanently protrudes from the anus and cannot be pushed back inside. This is the type that complicates into a thrombosed hemorrhoid.

Overall, even though internal hemorrhoids are not visible, painless and relatively harmless, it is a lot safer if you seek professional medical help, since bleeding is involved. You have to be 100% sure that the only cause of the bleeding is the presence of internal hemorrhoids and not some other existing disease.

One common cause of pain is the presence of a hemorrhoid. About half of the population by age 50 would have experienced rectal pain due to hemorrhoids.

Imagine you are in a formal function or in a public place, and then you suddenly had an attack of butt pain. You look around but there is no place to run for cover. You struggle not to touch and scratch your butt.

Has this happened to you?

Wouldn’t you vow to find out what is the cause of your pain and stop it?

How about starting now…

Hemorrhoids develop when the normal veins within your anus become abnormally enlarged or dilated. It can form above the anal opening where it is not visible or within the anal opening where it is visible.

When they are not visible, they are called internal hemorrhoids. Internal hemorrhoids range in size from a slight swelling under the wall of the anal canal to large sagging masses. The bigger they are in size, the more they are prone to prolapse or protrude out of the anal opening. A prolapsed hemorrhoid is considered a severe case of internal hemorrhoid.

Visible hemorrhoids are called external hemorrhoids. They appear grape-like and shiny due to the stretched skin. External hemorrhoids can become severe when it bleeds, pools in the skin and forms into a clot – producing a hard and painful lump. This lump is called a clotted or thrombosed hemorrhoid . You wouldn’t wish to have this kind of hemorrhoid. Find out why…

Most small internal hemorrhoids do not produce pain and are generally asymptomatic. They are sometimes left unnoticed and heal on their own even without any medical or conservative intervention. They are mostly painless because there is limited number of pain-sensing nerves above the anal opening.

However, external hemorrhoids can be responsible for most butt pain caused by hemorrhoids. This is because, aside from the numerous pain-sensing nerves within the anal canal, the location of external hemorrhoids is in the part of the skin that is constantly moving and shifting as we walk, bend, squat or sit. This makes every movement painful and uneasy.

The pain caused by external hemorrhoids can range from mild discomfort to extreme ones. Strangulated hemorrhoids are responsible for most excruciating rectal pains. You feel this kind of pain because blood supply is cut off from the hemorrhoid, depriving it with oxygen and in turn gangrene may set in.

Itchiness and burning sensations can also trigger rectal pain. These are the common problems faced by most people with hemorrhoids, and it is the very feeling of embarrassment felt by many. It is embarrassing because, in order to relieve the discomfort or the pain caused by itching, your instinct is to scratch the area. More so it is a “no, no” to scratch the insides of your butt just to relieve it, especially in public!

Whatever forms your rectal pain is, always remember that there are a lot of ways to relieve it (such as a Sitz Bath ) and most relief measure are just within your reach. You just have to know what your options are.