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Prolapsed Hemorrhoids (Piles) - Causes & Treatment

Piles that protrude outward from the anus are known as prolapsed piles. Pristyn Care provides advanced surgery for prolapsed piles in India. Contact us to book an appointment with the best proctologists to get rid of prolapsed piles.

Piles that protrude outward from the anus are known as prolapsed piles. Pristyn ... Read More

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  • What Are Prolapsed Piles?

    When veins in the anus or lower rectum get inflamed, they are known as piles. Prolapsed piles are inflamed veins inside the rectum that suddenly bulges out of the anus. These are different from external piles that appear on or around the skin of the anus, and internal piles that remain inside the rectum.

    Prolapsed piles are not painful but can cause bleeding, irritation, itching, and discomfort, especially while sitting or during bowel movements. Most of them are uncomplicated, but some severely prolapsed piles can burst, develop clots, or become entrapped in anal muscles and deprived of blood flow. A prolapsed pile can shrink with easy, at-home treatments and medications. However, surgery will be required for those that don’t shrink or take long to resolve.

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    Symptoms of Prolapsed Piles

    Common symptoms of prolapsed piles include:

    • A painless lump: One of the most common symptoms of a prolapsed pile is a painless lump in the anus. A soft but painless bump is often first found when wiping after a bowel movement. 
    • Bleeding: Blood on toilet paper or stool is a common symptom of prolapsed piles. Dark red blood signifies the bleeding is present further up the large intestine.
    • Itching and irritation: Anal itching is common with a prolapsed pile. The skin around the anus can also get irritated.
    • Mucus discharge: This whitish goo can develop due to rectal swelling. You can spot the mucus on stools or toilet paper after wiping.
    • Foul smell: If the mucus is present on stools or toilet paper, it may have a foul odor.
    • Incomplete evacuation: It is a feeling that the bowels are still full even after a bowel movement.
    • Fecal leakage: Fecal leakage, also known as fecal incontinence, is caused by the protrusion of tissues outside the anus, letting traces of stool to escape out.

    Are you going through any of these symptoms?

    Causes of Prolapsed Piles

    Some of the possible causes of prolapsed piles include:

    • Straining the bowels hard during your bowel movement
    • Family history of piles
    • Chronic constipation 
    • Sitting for long periods, particularly on the toilet

    Prolapsed piles are more likely to evolve if someone indulges in extreme physical activities like heavy lifting, is obese, or puts the body under much stress. They can also get irritated by anal sexual activity.

    Diagnosis and Treatment For Prolapsed Piles


    A proctologist can easily and quickly diagnose a prolapsed pile with the help of a physical examination. However, they can also perform a digital rectal exam. A digital rectal exam is a test that inspects and analyzes a person’s lower rectum, pelvis, and lower belly. This test can help the doctor check for piles and other medical issues, like prostate cancer, an abnormal mass in the rectum, or anus. 


    Most prolapsed piles shrink and return to normal in some time, but if the pile stays, the patient may need certain medications, or surgery. Treatment options for prolapsed piles include:


    There are several medical options available for the patient’s treatment for prolapsed pile, including:

    • Topical ointments, over-the-counter 
    • Stool softeners, over-the-counter

    Surgical procedures

    Prolapsed piles that cannot be treated with at-home treatments or medicines may require surgery to shrink or eliminate them. Surgery is the most reliable and effective way to treat piles and eliminate them altogether. The most effective and successful surgical options for prolapsed piles include:

    1. Laser surgery (laser hemorrhoidectomy) It is one of the most advanced and effective treatments for prolapsed piles. Laser hemorrhoidectomy is a procedure that uses laser energy to treat prolapsed piles. When this treatment is used, a diode laser reduces blood supply to anal cushions and shrinks piles mass. In addition, the smaller-sized laser beam improves the accuracy and precision of this procedure. 
    2. Stapled hemorrhoidectomy Under stapled hemorrhoidectomy, the doctor will relocate the piles and discontinue their blood supply with a stapler-like device. The piles will shrink and perish if they don’t get any blood. The patient will also heal quickly and have less itching and bleeding. 

    Other surgical options to treat prolapsed piles include:

    • Sclerotherapy– It is the procedure to inject a substance into a vein that causes it to shrink.
    • Coagulation– Infrared radiation is used to cut off blood supply to a vein, causing it to shrink.
    • Rubber band ligation: It is the most typical method of treating a prolapsed pile. In this procedure, a rubber band is tied around the pile’s base to restrict blood supply to the pile. As a result of this, the pile contracts.

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    List of Top Health Insurance Provider for Piles
    Insurance Providers FREE Quotes
    Aditya Birla Health Insurance Co. Ltd. Aditya Birla Health Insurance Co. Ltd.
    National Insurance Co. Ltd. National Insurance Co. Ltd.
    Bajaj Allianz General Insurance Co. Ltd Bajaj Allianz General Insurance Co. Ltd
    Bharti AXA General Insurance Co. Ltd. Bharti AXA General Insurance Co. Ltd.
    Future General India Insurance Co. Ltd. Future General India Insurance Co. Ltd.
    HDFC ERGO General Insurance Co. Ltd. HDFC ERGO General Insurance Co. Ltd.

    How To Prevent Prolapsed Piles?

    Some of the ways to prevent prolapsed piles include:

    • Ice application: A cold compress for 15 to 20 minutes several times a day can help reduce swelling in the anal region.
    • Sitz bath: A sitz bath is a warm water bath where you sit to reduce discomfort in the perineal region. Soaking this area in warm water soothes your anal sphincter muscles, which helps boost blood flow through your anal tissues. It promotes healing and relieves the pain, itching, and irritation from prolapsed piles.
    • High-fiber diet: You can keep the stools soft by eating fiber-rich foods and consuming plenty of water. In addition, fiber supplements may help.
    • Toilet habits: Avoid straining during bowel movements. To decrease irritation and itchiness, wash your anus with a spray bottle after bowel movements and dab gently with toilet paper or a wipe.
    • Gentle exercise: Gentle exercises like walking can help prevent constipation. Avoid weightlifting, squatting, or abdominal exercises that put stress on the rectum and anus.

    Complications Of Prolapsed Piles

    A prolapsed pile can become severely swollen, which can obstruct bowel movements and cause substantial bleeding. If the piles are large, the rupture of the underlying vein can lead to bleeding and a steep drop in blood pressure, causing dizziness, lightheadedness, and, in rare cases, shock and death. Other severe complications of prolapsed piles include:

    • Venous thrombosis: It happens when a blood clot develops inside the hemorrhoidal vein, which obstructs blood flow and causes the painful swelling of tissues.
    • Incarceration and strangulation. It happens when piles are incarcerated in anal muscles and deprived of blood flow (strangulated piles). It can lead to extreme pain and immediate tissue death, and gangrene.

    When To Consult A Doctor For Prolapsed Piles?

    You can consult a reliable and skillful proctologist in the following situations:

    • If your piles do not gradually reduce on their own, and they cause extreme discomfort that hinders routine activities.
    • Irregular bowel movements that lead to other digestive issues.
    • Sudden excessive bleeding from the anal region. 
    • The bulge of the lump becomes excessively big.
    • Red and itchy skin around the anus.

    Timely consultation with a medical expert for prolapsed piles will help treat it using medications, as the expert recommends. In some instances, the doctor will also recommend surgical treatment to prevent any life-threatening situations.

    Common FAQs Around Prolapsed Hemorrhoids

    Is it safe to push a prolapsed hemorrhoid back in?

    Yes, it is normally safe to push a prolapsed hemorrhoid back in. Doing so can protect your blood vessels and decrease the risk of complications. However, if your piles cannot be pushed back in, consult a doctor immediately. 

    Why do piles prolapse?

    There are several reasons why piles prolapse, including:

    • Increased pressure in the rectal or anal area
    • Weakened tissue in the rectal or anal area
    • Insufficient lubrication during bowel movements.

    Do prolapsed piles always smell?

    Prolapsed piles don’t always smell but can if the mucus is present. The smell may be fishy or rotten.

    What do prolapsed piles look like?

    Prolapsed piles look like swollen red lumps or bumps peeking out of the anus. You can also spot them using a mirror to examine this area. 

    What is the average age for laser surgery for prolapsed piles?

    Laser surgery for prolapsed piles is the most popular treatment among patients aged 31-50 (40%), while it is the 3rd most popular for ages 51-75 (22%) and 2nd most popular for ages 18-30 (29%).

    What is the recovery time after prolapsed piles surgery?

    After surgery for prolapsed piles, it generally takes 4 to 8 weeks to heal and resume routine activities. Furthermore, your doctor will insist on having the first bowel movement within 48 hours of surgery with the help of stool-softening medications.

    Which doctor to consult for prolapsed piles?

    Consulting an experienced proctologist for advanced prolapsed piles treatment is the best way to eliminate the disease as soon as possible. 

    Are rectal prolapse and prolapsed piles the same?

    Though the symptoms are common for prolapsed piles and rectal prolapse, they are still different. Rectal prolapse occurs when the attachment that keeps the rectum within the body is lost, resulting in the rectum falling out from the anus. In contrast, a prolapsed pile is the protrusion of the tissues in the lower rectum of the intestine. In addition, prolapsed piles happen more commonly than rectal prolapse. 

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    Content Reviewed By
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    Dr. Sanjeev Gupta
    25 Years Experience Overall
    Last Updated : July 5, 2024

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