A prolapsed hemorrhoid is an internal hemorrhoid that has become so swollen that it protrudes outside of the anal canal. Although they are outside the anal opening, they are considered internal hemorrhoids because they originate inside.
Internal hemorrhoids are classified into four different categories.
- First degree hemorrhoids are those that have not yet prolapsed, or protruded, from the anal opening.
- Second degree hemorrhoids are those that protrude from the anus but they will retract on their own after a bowel movement. Such hemorrhoids are usually not painful.
- Third degree hemorrhoids protrude from the anus but they need to be manipulated into the anal canal. This means that they will not retract on their own and usually must be pushed back in with a finger or swab.
- Fourth degree prolapsed hemorrhoids are considered to be the most severe. They cannot be reinserted into the anus.
This classification system is important because it affects the kind of treatment that will be used to treat the hemorrhoid.
Prolapsed hemorrhoids are often accompanied by a number of symptoms. The symptoms may be mild and include itching or burning or some bleeding or they may be more serious with severe pain. Prolapsed hemorrhoids are caused by a variety of factors. The most commonly sited are straining during bowel movements, insufficient fiber in the diet, and a sedentary lifestyle. Other culprits can include obesity, smoking, and high blood pressure.
Because the cause of the condition varies, there are many possible treatments. The most common treatments (and preventative measures) include drinking more fluids such as water and raw fruit juices with pulp, increasing the amount of fiber in the diet, and exercising more to strengthen muscles in the lower abdominal area.
The treatment for prolapsed hemorrhoids varies depending on the severity. Because first degree hemorrhoids are often asymptomatic, they require no treatment. Second and Third degree hemorrhoids can be treated with a variety of home treatments including the topical application of creams and gels as well as some herbal remedies such as witch hazel and aloe vera. Sitz baths can also be an effective treatment.
Additional herbal remedies such as Butcher's Broom, Horse-Chestnut, Neem, and certain bioflavanoids have been reported to be successful in dealing with these conditions. Increasing blood flow by moving around and/or by keeping legs elevated while sitting have also been reported to help.
Some prolapsed hemorrhoids require medical intervention. Prolapsed hemorrhoids may become thrombosed that is they may form a blood clot. These are typically more painful that those without thrombosis. In addition, thrombosed hemorrhoids may become strangulated and this could lead to gangrene-a life-threatening condition that requires immediate medical intervention.
Typical medical treatments involve removing the offending hemorrhoid. The hemorrhoid is removed and a number of options for this removal can be had. The most common treatment in the US is the rubber band ligation. In this procedure elastic bands are placed at the base of the hemorrhoids cutting off the blood flow. Then the hemorrhoid is allowed to fall off. This option may require several treatments to completely remove the hemorrhoid.
Another option is the hemorrhoidectomy, or surgical removal of the hemorrhoid. The hemorrhoidectomy procedure consists of cutting out or otherwise removing the hemorrhoid. It can require relatively long recovery times and post-surgical pain. Hemorrhoidectomies are usually reserved for Fourth degree hemorrhoids.
The information contained in this article is not meant to be taken as medical advice. It is intended for your information only. When in doubt or if you have questions, please consult your doctor.