A prolapsed rectum typically looks like a reddish, fleshy lump protruding from the anus. It may be small and barely noticeable, or it may extend several inches outward depending on severity. The tissue is moist, soft, and pink to dark red in color. What you’re seeing is the inner lining of the rectum pushing through and outside the anal opening, most often during or after a bowel movement.
Rectal prolapse affects about 0.5% of the general population. Women over 50 are six times more likely than men to develop it, though men who do tend to be younger, often under 40.
Partial vs. Full-Thickness Prolapse
Not all rectal prolapse looks the same. The appearance depends on how much tissue has slipped out of place, and there are two main types you might see.
A partial (mucosal) prolapse involves only the inner lining of the rectum pushing outward. It’s less pronounced and typically appears as a small, soft bulge of pinkish tissue around the anal opening. The protrusion is usually short, sometimes just a centimeter or two, and may only appear when you strain during a bowel movement before slipping back inside on its own.
A full-thickness prolapse is more dramatic. The entire wall of the rectum, not just the lining, pushes through the anus. This creates a longer, more cylindrical mass of tissue that can hang several inches outside the body. One of the most distinctive visual features of a full-thickness prolapse is concentric circular rings on the surface of the tissue, like rings on a target. These circular folds are a key identifier. A full-thickness prolapse frequently needs to be pushed back inside manually because it won’t retract on its own.
How It Differs From Hemorrhoids
Many people who notice tissue protruding from the anus assume they have hemorrhoids, and the two conditions can look similar at first glance. But there are reliable visual differences.
Prolapsed hemorrhoids appear as one or more irregular lumps of tissue. They tend to be shorter, separated, and clustered in distinct spots around the anus. The folds of hemorrhoid tissue run in a radial pattern, like spokes on a wheel pointing outward from the center.
Rectal prolapse, by contrast, looks like a single, uniformly rounded structure. The tissue is longer and more symmetrical, and the surface folds run in concentric circles around the mass rather than radiating outward. If you see a round, tube-like protrusion with ring-shaped folds, that pattern points toward prolapse rather than hemorrhoids.
What It Feels Like
Beyond the visual, most people with rectal prolapse describe a feeling of pressure or a bulge in or around the anus. You might feel like something is sitting just inside the anal opening, or like there’s tissue left behind after a bowel movement that you can’t fully pass. Some people describe it as sitting on a ball.
The protruding tissue itself is soft, moist, and slightly slippery to the touch because it’s mucous membrane, the same type of tissue that lines the inside of your cheeks. It may leak mucus, small amounts of blood, or stool, which can cause irritation, itching, and staining of underwear. Over time, friction and exposure of this normally internal tissue can lead to small ulcers or sores on the surface, which may bleed and cause discomfort.
Internal Prolapse You Can’t See
In some cases, the rectum folds in on itself internally without ever protruding outside the body. This is called internal rectal prolapse, or intussusception. You won’t see any visible lump with this type, which makes it harder to identify. The main clues are functional: difficulty fully emptying your bowels, a persistent feeling of incomplete evacuation, and sometimes pelvic pressure or pain during straining. Because there’s nothing visible externally, internal prolapse usually requires imaging (a specialized type of MRI or X-ray taken during a bowel movement) to confirm.
Color Changes That Signal Trouble
Healthy prolapsed tissue is pink to reddish and moist. The color matters because it tells you whether the tissue is still getting adequate blood flow.
If prolapsed tissue stays outside the body for an extended period, the anal muscles can tighten around it and cut off circulation, a situation called strangulation. When this happens, the tissue shifts from pink-red to a deeper purple, dark red, or eventually blackish color. It may swell significantly, become firm or hard, and cause intense pain. Dark discoloration signals that the tissue is losing blood supply, and this is a situation that needs emergency medical attention because the tissue can begin to die.
How Prolapse Progresses Over Time
Rectal prolapse tends to worsen gradually. In early stages, you might notice a small amount of tissue that appears only during straining and retracts on its own afterward. Over months or years, the prolapse may begin appearing with less effort, during activities like standing, walking, or coughing. Eventually, the tissue may stay outside the body most of the time, requiring you to push it back in with your hand after each bowel movement. At its most advanced stage, the rectum protrudes and can no longer be pushed back inside at all.
The progression isn’t inevitable for everyone, but rectal prolapse does not resolve on its own. Surgery is the primary treatment for full-thickness prolapse, with several approaches depending on severity and overall health. Most procedures aim to anchor the rectum back in its normal position inside the pelvis.