Both rectal prolapse and hemorrhoids can look surprisingly similar, especially when hemorrhoids begin to prolapse. Understanding the difference is important because each condition requires a different treatment approach. At Advanced Vascular & Vein, we specialize in minimally invasive hemorrhoid embolization, a modern treatment option for people whose hemorrhoids are causing persistent bleeding and/or swelling.
What Are Hemorrhoids?
Hemorrhoids are swollen veins in the lower rectum and anus. They are incredibly common and come in two main types:
Internal Hemorrhoids
These form inside the rectum. You usually can't see or feel them unless they prolapse, meaning they slip out through the anus. Prolapsed internal hemorrhoids are a major reason people confuse hemorrhoids with rectal prolapse.
Typical symptoms include:
-
Bright red bleeding during bowel movements
-
Itching or irritation
-
A soft, moist lump at the anal opening if they prolapse
-
Mild discomfort or pressure
Prolapsed hemorrhoids often retract on their own or can be gently pushed back.
External Hemorrhoids
These develop under the skin around the anus. They may become painful if they clot (thrombose), but they do not cause rectal prolapse.
Typical symptoms include:
-
A tender lump near the anus
-
Painful swelling
-
Itching or irritation
Hemorrhoids can bleed, itch, or feel swollen, but they do not involve the rectum turning inside out.
What Is Rectal Prolapse?
Rectal prolapse is very different. It occurs when the rectum (the last section of the large intestine) loses its normal support and slides outside the body through the anus. This condition involves the rectal wall itself, not veins like hemorrhoids.
Types of rectal prolapse include:
-
Full-thickness prolapse: the entire rectal wall protrudes
-
Mucosal prolapse: only the lining slips out
-
Internal prolapse: the rectum folds inward but does not protrude externally
This condition typically requires evaluation by a colorectal specialist.
Typical rectal prolapse symptoms include:
-
A circular, tube-like protrusion that may look reddish and moist
-
A feeling of something "falling out"
-
Mucus discharge
-
Difficulty controlling bowel movements
-
A sensation of incomplete emptying
Unlike prolapsed hemorrhoids, rectal prolapse does not shrink back easily.
Rectal Prolapse vs Hemorrhoids: Key Differences
1. Appearance
This is where confusion is most common.
Hemorrhoids
-
Look like small, grape-like lumps
-
Tend to be localized bumps
-
May be purple, bluish, or flesh-colored
-
Prolapsed internal hemorrhoids appear as soft, moist tissue folds
Rectal Prolapse
-
Appears as a larger, cylindrical, concentric ring of tissue
-
Often looks like a "tube" turning outward
-
More uniform in shape than hemorrhoids
-
Extends farther out than prolapsed hemorrhoids
If you see a circular pattern of folds (almost like the opening of a sleeve), that is more suggestive of rectal prolapse.
2. Symptoms
Another way to tell them apart is by how they feel.
Hemorrhoid symptoms:
-
Itching
-
Bleeding with bowel movements
-
Swelling
-
Pain if external hemorrhoids clot
-
A lump that may come out during bowel movements and go back in
Rectal prolapse symptoms:
-
Difficulty controlling gas or stool
-
Mucus leakage
-
A persistent sensation of heaviness or pressure
-
Tissue that stays out even after standing up
-
A bulge that worsens over time
If you have incontinence, mucus drainage, or a bulge that remains outside, rectal prolapse becomes more likely.
3. Behavior During Movement
This is a highly useful distinction.
-
Hemorrhoids often retract when you stand, rest, or gently push them back.
-
Rectal prolapse tends to stay out, especially in later stages.
When to See a Doctor
You should seek medical care if you notice frequent or heavy rectal bleeding or if you see tissue protruding from the anus. It is also important to get evaluated if you experience difficulty with bowel movements, a persistent feeling of incomplete emptying, or pain that worsens or does not improve over time. Mucus leakage, trouble controlling stool, or a bulge that does not go back inside are additional signs that you should schedule an appointment. These symptoms do not automatically mean something serious is happening, but they do indicate that it's time for a professional evaluation.
How Advanced Vascular & Vein Can Help
While rectal prolapse usually requires a colorectal surgeon, Advanced Vascular & Vein specializes in treating hemorrhoids using a modern, minimally invasive method called hemorrhoid embolization.
What Is Hemorrhoid Embolization?
Hemorrhoid embolization is a non-surgical procedure performed by an interventional radiologist. It works by reducing blood flow to the swollen hemorrhoidal veins, which shrinks them and decreases symptoms.
Benefits include:
-
No surgical incision
-
Less pain than traditional hemorrhoid surgery
-
Quick recovery
-
Effective for bleeding and prolapsing hemorrhoids
-
Performed in an outpatient setting
Many patients choose hemorrhoid embolization when they want relief from hemorrhoid symptoms without the downtime of surgery.
Why Evaluation Matters
Because prolapsed hemorrhoids can look similar to rectal prolapse, it's important to identify the correct condition before choosing treatment. Our team can help determine whether your symptoms are hemorrhoid-related and, if so, whether embolization may be an appropriate option.
Final Thoughts
Confusing rectal prolapse with hemorrhoids is incredibly common; both can cause bulging, discomfort, and embarrassment. But the two conditions are very different and require different treatments.
The good news is that both are treatable. If you are experiencing swelling, bleeding, or a prolapse-like bulge, the team at Advanced Vascular & Vein can evaluate your symptoms and determine whether hemorrhoids may be the cause. If they are, minimally invasive hemorrhoid embolization could offer the relief you've been looking for. Call us today at 678-284-2573 for more information.
