Prolapsed Hemorrhoid: What It Means and What to Do

A prolapsed hemorrhoid is what happens when an internal hemorrhoid pushes outside the anal opening instead of staying tucked inside where it normally sits. It’s one of the more alarming things to discover, mostly because it’s visible and tangible in a way earlier-stage hemorrhoids aren’t — but the grade it’s reached, and whether it goes back in on its own, determine almost everything about what happens next.

How it’s graded

Grade	What’s happening
I	No prolapse; stays inside at all times
II	Prolapses during straining, goes back in on its own
III	Prolapses and needs to be manually pushed back in
IV	Permanently prolapsed; can’t be pushed back in

A single prolapse episode isn’t automatically grade III or IV — grade is about the typical, repeated pattern, not one bad day. If it happened once during a particularly hard bowel movement and reduced on its own, that’s more consistent with grade II than a permanent change in status.

What it feels like

A prolapsed hemorrhoid is usually described as a soft, sometimes tender lump you can feel or see at the anal opening, often most noticeable right after a bowel movement. Grade II and III prolapse is frequently uncomfortable rather than acutely painful — sharp, severe pain is more typical of a thrombosed hemorrhoid, a different (though sometimes overlapping) situation where a clot has formed inside the tissue.

Can you push it back in yourself?

For grade III prolapse, yes, gently, is often part of standard guidance — using a clean, lubricated finger to press the tissue back through the anal opening after a bowel movement, ideally not forcefully. If it won’t go back in with gentle pressure, or the attempt causes significant pain, stop and see a doctor rather than continuing to push.

Home measures that help mild prolapse

• Sitz baths reduce swelling, which can make reduction easier and less uncomfortable
• Avoiding further straining is essential — continued straining keeps re-prolapsing tissue that’s trying to settle
• Gentle cleaning with water rather than dry wiping reduces irritation to already-stretched tissue
• Elevating your legs briefly while resting can ease swelling for some people

When it needs a procedure

Grade III hemorrhoids that keep prolapsing despite habit changes are commonly treated with rubber band ligation, which is generally effective at this stage. Grade IV — permanently prolapsed — usually needs a more involved approach, sometimes surgery, since banding is less suited to tissue that never returns inside on its own. Our guide to what rubber band ligation actually involves covers what that procedure looks like in practice.

Warning signs that mean urgent care, not home management

A prolapsed hemorrhoid that becomes increasingly painful, turns dark purple or blue, or is accompanied by fever needs urgent evaluation — these can point to strangulation, where the blood supply to the tissue is cut off, which is a genuine medical emergency rather than a routine flare.

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Frequently Asked Questions

Is a prolapsed hemorrhoid the same as a thrombosed one?

No, though they can occur together. Prolapse describes tissue pushing outside; thrombosis describes a clot forming inside a hemorrhoid, which is a separate, often more painful problem.

Will a prolapsed hemorrhoid eventually stop happening on its own?

Grade II prolapse can improve with better habits over time. Grade III and IV are less likely to resolve without a procedure.

Is it safe to push it back in myself?

Gently, yes, for a prolapse that isn’t severely painful. If it resists or hurts significantly, stop and get it checked rather than forcing it.

How urgent is a prolapse that won’t go back in?

Same-day or next-day medical attention is reasonable for a persistent, uncomfortable prolapse; immediate care if it’s turning dark, increasingly painful, or you have a fever.

What to Read Next

• Hemorrhoid Grades 1 to 4 Explained
• Thrombosed Hemorrhoid: Symptoms and Treatment
• Rubber Band Ligation: What to Expect