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Hemorrhoid vs. Rectal Prolapse: Key Differences, Symptoms, and Treatment Options

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When it's about the discomfort in the digestive tract, two conditions are commonly confused- hemorrhoids (piles) and rectal prolapse. While both involve the anus and rectum that are affected, they are different issues with distinct symptoms, causes, and even treatments. Understanding hemorrhoids vs. rectal prolapse can help detect what is happening in the body and seek appropriate and timely medical care. This blog will guide on piles vs rectal hernia based on several factors. Additionally, we’ll discuss preventive tips to avoid their recurrence.

Hemorrhoid vs Rectal Prolapse: Key Differences in the Symptoms

These are the symptoms that set hemorrhoid and rectal prolapse apart:

Symptoms of Hemorrhoids

Symptoms of a Rectal Prolapse

  • Blood in your stool

  • Pain and irritation around your anal area

  • Swelling or hard lumps around your anal area

  • Itchiness around the anus

  • Constipation or itching in the anus

  • Bulge of your anus after sneezing, coughing, or lifting 

  • Pain and rectal bleeding 

  • Mucous discharge in your stool

  • Pressure in your rectum

Hemorrhoid vs Rectal Prolapse: Difference in the Causes 

Causes of Hemorrhoids:

These are the different causes of hemorrhoids:

  • Pregnancy: A study reports that hemorrhoids are common during pregnancy due to extreme pressure on the rectum and anus’s veins. 

  • Aging: People after the age of 45 years or who have chronic constipation develop it.

  • Obesity: The constriction of the veins and blood vessels in the anus and colon due to excessive weight can make blood supply difficult.

  • Heavy lifting: Straining activities can put excessive strain on the rectum and abdomen. 

  • Straining while pooping: Due to constipation, straining while pooping can also lead to hemorrhoids. 

  • Genetic factors:  A family history can increase the chances of hemorrhoids.

Causes of Rectal Prolapse:

They may include:

  • Chronic constipation or diarrhea: This can naturally weaken the intestines' muscles due to frequent straining during bowel movements.

  • Weak pelvic floor muscles: As these muscles support the rectum, aging, and injuries can weaken them, leading to prolapse.

  • Vaginal deliveries: Multiple vaginal childbirths or tough labor may also cause damage to the pelvic muscles.

  • Nerve damage: Nerve disorder or spinal cord injuries can disrupt bowel control, causing rectal prolapse.

  • High abdominal pressure: Obesity, chronic coughing, or heavy lifting can put extreme strain on the rectum.

  • Aging: With age, tissues, and muscles supporting the rectum can become weak naturally, making rectal prolapse highly common in older adults.

Hemorrhoid vs Rectal Prolapse: Difference in the Diagnosis

Diagnosis of Hemorrhoids:

Hemorrhoids are diagnosed after a physical examination by the doctor. The providers may perform these diagnostic tests to detect the exact cause:

  • Digital rectal examination: Insert the finger inside the rectum to check for any issues.

  • Anoscopy: Puts a hollow, lighted tube inside the anus to examine the internal hemorrhoids.

  • Proctoscopy: Inserts a lighted tube inside the anus to check the entire rectum.

  • Sigmoidoscopy: Uses a flexible, lighted tube that helps blow air and make the rectum swell up, giving a clear view of the large intestine.

  • Coloscopy: Help check for red or swollen tissue, abnormal growths, ulcers, or bleeding in the entire area of the large intestine.

Diagnosis of Rectal Prolapse:

With physical examination, the healthcare providers may also suggest these tests:

  • Digital Rectal Exam: Insert the finger inside the rectum to check for any issues.

  • Videofecogram: This takes an X-ray or MRI during a bowel movement.

  • Anorectal manometry: Involves inserting a tube to measure the tightness and strength in the anal sphincters.

  • Barium enema: Includes taking several video X-rays of the lower part of the gastrointestinal tract to diagnose functional or structural abnormalities of the rectum or large intestine.

  • Colonoscopy: Uses a flexible scope to examine the inner area of the large intestine.

  • Electromyography (EMG): To check for nerve damage in the anal sphincters and also examines muscle coordination.

Hemorrhoids vs Rectal Prolapse: Key Difference in the Treatments

Treatment for Hemorrhoids: 

  • Over-the-counter medications: Acetaminophen or ibuprofen to relieve pain and swelling or numbing medicines.

  • Fiber supplements: To make the stools soft and prevent straining.

  • Lifestyle changes: Addition of fiber-rich foods to the diet and regular pelvic massages or sitz baths to relieve muscle strain. 

  • Surgical procedures: Hemorrhoidectomy (the removal of hemorrhoids) in severe cases.

Treatment for Rectal Prolapse: 

  • Conservative management: Increase fiber intake, practice pelvic floor exercises, and use stool softeners or laxatives.

  • Surgical procedure: Perineal repair to reposition or Delorme procedure to remove the prolapsed part of the rectum.

  • Pessary: A device is inserted into the rectum to support the prolapsed part of the rectum.

Also, Read Best Homeopathic Medicine for Piles Treatment.

Complications Associated with Hemorrhoids and Rectal Prolapse

Complications Associated with Hemorrhoids:

  • Anemia

  • Thrombosed hemorrhoids (blood clots in hemorrhoids)

  • Infection

  • Strangulated hemorrhoids

  • Prolapse

  • Fecal incontinence

Complications Associated with Rectal Prolapse:

According to research, the reported complications associated with rectal prolapse are:

  • Rectal ulcers

  • Fecal incontinence

  • Constipation

  • Incarceration (a rectal prolapse can't be pushed back)

How will a Patient Differentiate Between Hemorrhoids and Rectal Prolapse?

In many cases, the symptoms of hemorrhoids and rectal prolapse are common. However, the patients can keep these points in mind while finding out about their condition:-

Hemorrhoids

  • Hemorrhoids can be in the inner layer of the bowel near the anal opening.

  • They do not have any symptoms before occurring.

  • They are swollen and painful lumps.

  • In the advanced stages, hemorrhoids can become more painful and complicated.

Rectal prolapse

  • Rectal prolapse is when the entire bowel segment is higher outside the body.

  • They can have severe problems and signs like leaking stools.

  • Rectal prolapse can be associated with the fullness of the bowels.

  • It involves the formation of concentric circles.

  • Rectal prolapse is a complete prolapse wherein the colon is seen outside the anus.

Prevention Tips for Both Conditions

Consider these tips to reduce the chances of developing both conditions:

  • Consume high-fiber-rich foods: Eat fruits, whole grains, and vegetables every day as they are highly rich in fiber and help soften stool and prevent constipation.

  • Staying hydrated: Drink a lot of water for proper hydration that maintains soft stools.

  • Exercise regularly: Physical activities can improve bowel function and prevent the strain on the rectum. However, avoid heavy lifting to prevent too much pressure on the rectum.

  • Avoid straining while pooping: Don’t push too hard when pooping to avoid excessive pressure.

  • Practice good hygiene: Gently clean the anal area after bowel movements to avoid irritation.

  • Avoid sitting for extended hours: If your work involves long hours of sitting, the best advice is to take breaks to prevent pressure on the rectal veins.

  • Maintain a healthy body weight: Helps alleviate excessive strain on the pelvic muscles & rectum.

  • Practice pelvic floor muscles: Exercises such as Kegels can help strengthen the pelvic floor muscles and rectum.

  • Treat chronic constipation or diarrhea: If you have these conditions, seek medical treatment to manage and prevent them.

  • Seek medical care for pelvic health problems: Manage your issues related to pelvic floor dysfunction by seeking early medical treatment. 

Difference in the Cost of Treatment of Hemorrhoids and Rectal Prolapse

The cost of treatment for either of the conditions will depend on the severity of the disease.

  • Usually, the cost of treatment of hemorrhoids is less than rectal prolapse, as hemorrhoids can be treated with medications and lifestyle changes.

  • Hemorrhoids are not severe and can require laser treatment, which will not cost much for the patient. The treatment cost of hemorrhoids is between 30,000 to 1 lakh rupees.

  • However, a rectal prolapse may require surgery to lift the rectal and put it back in the gut. This can cost more than 1 lakh rupees. 

Final Thoughts

Understanding hemorrhoids vs rectal prolapse is crucial for early detection and treatment. Though these are both in the same part of the body, there are differences in diagnosis, symptoms, causes, and treatments. Though rectal prolapse will require surgery, hemorrhoids can be treated with lifestyle changes. To eliminate the conditions, patients must adopt a healthier lifestyle and a high-fiber diet. Though some severe conditions might require surgery, it will be best to get in touch with the doctor if there are any inconveniences.

Frequently Asked Questions

Does rectal prolapse look like hemorrhoids?

Rectal prolapse occurs when the rectum or part of the intestine slips down the anus. It is caused by weakening the muscles that hold it in place. Rectal prolapse may feel like hemorrhoids.

Is hemorrhoid considered a prolapse?

When the veins in the anus or the rectum swell up, then hemorrhoids are developed. Hemorrhoids are bulges outside the anus and can result in pain in the anus

Is rectal prolapse hard or soft?

Rectal prolapse happens when the last portion of the colon, i.e., the anus, protrudes outside the body. One can feel the smaller lumps of soft tissues extending outside the body.

How to know if you have rectal prolapse?

They help diagnose rectal prolapse and rule out conditions like hemorrhoids or fissures. The doctor will usually check by inserting their figures into the rectum and checking the strength of the sphincter muscles.