Prolapsed haemorrhoids (also known as prolapsed hemorrhoids) are a more advanced and often uncomfortable form of haemorrhoidal disease. While many people experience haemorrhoids at some point in their lives, prolapse occurs when internal haemorrhoids enlarge and extend outside the anal canal. If you have been searching for prolapsed hemorrhoids information, this article explains how they develop, who is most at risk, and which treatment options are available to help individuals seek timely and appropriate medical care.
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What Are Haemorrhoids?
Haemorrhoids, also commonly referred to as piles, are swollen blood vessels located in and around the rectum and anus. They develop when increased pressure causes these veins to enlarge and become inflamed. Haemorrhoids can be internal, forming inside the rectum, or external, forming under the skin around the anus.
For a detailed explanation of haemorrhoids, their symptoms, diagnosis, and treatment options, you may refer to this comprehensive guide:
How Haemorrhoids Become Prolapsed
Prolapsed haemorrhoids occur when internal haemorrhoids progress beyond their normal position. As pressure within the rectum increases over time, the supporting tissues weaken. Eventually, the haemorrhoidal tissue begins to descend and protrude through the anus.
Prolapse is commonly classified into four grades:
- Grade I: Haemorrhoids remain inside the rectum.
- Grade II: Haemorrhoids prolapse during bowel movements but retract on their own.
- Grade III: Haemorrhoids prolapse and require manual repositioning.
- Grade IV: Haemorrhoids remain permanently prolapsed and cannot be pushed back.
At this stage, prolapsed haemorrhoids may also be referred to as prolapsed hemorrhoids, particularly in American medical literature.
Who Is Most At Risk Of Prolapsed Haemorrhoids?
While general haemorrhoids are common, certain factors specifically increase the risk of prolapse rather than mild disease alone.
Individuals at higher risk include:
- People with chronic constipation or persistent straining
- Those who experience frequent diarrhoea
- Individuals with prolonged sitting habits, especially during bowel movements
- Older adults, as connective tissues weaken with age
- Pregnant women, due to increased pelvic pressure
- People who frequently lift heavy objects
- Individuals with untreated or recurrent internal haemorrhoids
Unlike early-stage piles, prolapsed haemorrhoids are more likely to cause ongoing symptoms and complications if left untreated.
Health Implications Of Prolapsed Haemorrhoids
Prolapsed haemorrhoids can significantly impact quality of life. Common symptoms include:
- Persistent anal discomfort or pain
- Rectal bleeding during or after bowel movements
- A visible or palpable lump outside the anus
- Mucous discharge or irritation
- Difficulty maintaining hygiene
In more severe cases, prolapsed haemorrhoids may become strangulated, meaning their blood supply is compromised. This can lead to intense pain, swelling, and an increased risk of infection or thrombosis. These complications often require prompt medical evaluation.
Treatment Options For Prolapsed Haemorrhoids
Treatment depends on the severity of the prolapse and the symptoms experienced.
Conservative Management
For early prolapse, lifestyle and dietary changes may help reduce symptoms:
- Increasing dietary fibre intake
- Drinking adequate fluids
- Avoiding prolonged straining
- Using stool softeners when necessary
These measures may relieve symptoms but often do not reverse advanced prolapse.
Non-Surgical Medical Treatments
When symptoms persist, doctors may recommend procedures such as:
- Rubber band ligation, which cuts off blood supply to the haemorrhoid
- Sclerotherapy, involving injection of a solution to shrink the haemorrhoid
- Infrared coagulation, which uses heat to reduce blood flow
These treatments are typically used for Grade II or selected Grade III prolapsed haemorrhoids.
Surgical Treatments
Advanced cases, especially Grade III and IV prolapse, may require surgery. Options include:
- Haemorrhoidectomy, the surgical removal of haemorrhoidal tissue
- Stapled haemorrhoidopexy, which repositions prolapsed tissue and reduces blood flow
Surgical treatment is generally effective and provides long-term relief when conservative methods are insufficient.
Preferred Doctors (Colorectal Surgeons)
If you are experiencing symptoms of prolapsed haemorrhoids, it is important to consult a qualified medical professional for accurate diagnosis and personalised treatment. We work with trusted partner doctors and clinics in Singapore who are experienced in managing haemorrhoidal conditions. These specialists can assess the severity of prolapse and recommend appropriate medical or surgical options based on your individual needs. You can consider:
- Dr Chong Choon Seng is a highly experienced colorectal surgeon in Singapore known for his expertise in minimally invasive and robotic techniques for colorectal cancer, polyps, and complex anorectal conditions. With extensive training and years of surgical practice, he is trusted for delivering safe, precise, and evidence‑based care tailored to each patient’s needs.
- Dr Lee Kuok Chung is a highly experienced colorectal surgeon with nearly 20 years of practice, specialising in minimally invasive and robotic surgery for colorectal cancer and complex perianal conditions. He is also one of the few surgeons in Singapore skilled in advanced endoscopic techniques such as EMR and ESD, allowing large polyps and early cancers to be removed without major surgery.
- Dr Daniel Lee is a highly experienced colorectal surgeon in Singapore, known for his expertise in minimally invasive techniques such as laparoscopic colorectal surgery, TAMIS, and advanced laser procedures for piles, fistulas, and pilonidal disease. Dr Lee is trusted for handling even the most challenging cases.
Dr Chong Choon Seng 张峻诚医生
[SG] Featured Doctor- Dr Kevin Koo
When To Seek Medical Advice
You should seek medical attention if you experience persistent bleeding, increasing pain, or a prolapsed haemorrhoid that does not reduce. Early evaluation can prevent complications and improve treatment outcomes.
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