Can you push a prolapsed hemorrhoid back in, and how do you do it safely?
In adults with a prolapsed (externally protruding) internal hemorrhoid, does manual digital reduction back into the anal canal safely relieve symptoms and reduce the risk of complications such as incarceration, strangulation, or thrombosis, compared with leaving it to reduce spontaneously or not reducing it?
How people search for this, in their own words
- “how far to push hemorrhoids back in”
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- “do hemorrhoids come back”
- “why hemorrhoids keep coming back”
Evidence review in plain language · compiled 2026-10-13 · checked 2026-10-13 · next 2026-11-13 · automated review, how it works
What the evidence says
Bottom line
No study has tested whether pushing a prolapsed hemorrhoid back in with your finger is safe or helps.
The 12 related studies found look at drugs, injections, banding, and surgery for hemorrhoids, not the act of manually pushing a prolapsed hemorrhoid back in. The only report that actually describes someone doing this is a single case where it led to a serious infection in a person whose immune system was weakened by chemotherapy.
How certain
Very low
The 12 human studies found measure a related question rather than this one, so they can only be read indirectly.
What it shows
Not studied
No study has measured this outcome in people with this condition.
- answer it directly
- 0answer it directly
- studies found
- 20studies found
- randomised trials
- 2randomised trials
- people studied
- 1,673people studied
- review of trials
- 1review of trials
- years covered
- 2022–2026years covered
What the research shows
Symptom relief (pain, swelling)
No study measured pain or swelling relief specifically from pushing a prolapsed hemorrhoid back in. Trials of oral drugs and creams measured symptom scores for hemorrhoids generally, but that is a different question.
Not studied
Successful resolution of prolapse
No study measured whether manual reduction successfully resolves a prolapse, or compared it with leaving the hemorrhoid to go back in on its own.
Not studied
Incidence of incarceration or strangulation
One case report describes a serious complication (tissue erosion and infection) after someone pushed a prolapsed hemorrhoid back in, but this was a single person with a weakened immune system from cancer chemotherapy. No study counted how often incarceration or strangulation happens after manual reduction.[1]
Insufficient evidence
Incidence of thrombosis
No study tracked whether manually pushing a hemorrhoid back in makes a blood clot (thrombosis) inside it more or less likely.
Not studied
Need for emergency or urgent surgery
Reviews of anorectal emergencies describe when surgery becomes necessary, such as for gangrenous prolapse, but none tested whether manual reduction changes how often that happens.[1]
Not studied
Recurrence of prolapse within 3-12 months
No study has tracked whether a hemorrhoid that is pushed back in is likely to prolapse again in the weeks or months afterward.
Not studied
Important limitations
- All of the studies found compare medical, injection, banding, or surgical treatments against each other. None of them study the simple act of pushing a prolapsed hemorrhoid back in with a finger.[1,2,3]
- The only report close to this question is a single case of a woman being treated for breast cancer, whose immune system was severely weakened by chemotherapy. She developed a severe infection with an eroded hemorrhoid, was treated with antibiotics, immune support, and multiple wound-care measures together, and recovered after 30 days. The case does not show whether the infection was caused by manual reduction, and it is not a planned safety study of the technique or representative of most people.[1]
- Most of the related studies are small, retrospective, or single case series, graded low or very low quality, so even the indirect information available is shaky.[1,2,3,4,5]
Why people try it
- It can stop the uncomfortable feeling of something sticking out or rubbing on clothing.
- It feels like a fast fix that avoids an embarrassing trip to the doctor.
- Online forums and home-remedy advice often suggest pushing it back in.
- It can temporarily reduce the visible bulge and the pressure that comes with it.
What the studies found
- Found a benefit9 · 45%
- Mixed or unclear11 · 55%
What kind of studies
- Narrative review5 · 25%
- Retrospective4 · 20%
- Case series3 · 15%
- Guideline3 · 15%
- Randomised trial2 · 10%
- Prospective cohort2 · 10%
- Systematic review1 · 5%
The studies that decided it
Ye et al. 2026
A case report on the management of sepsis complicated by eroded mixed hemorrhoids following breast cancer chemotherapy
Pushing it back in caused serious infection.Case seriesVery low qualityRelated question
1 people30 days
after 30 days of treatment, fever resolved and the eroded hemorrhoid healed completely
- Who was studied
- woman with breast cancer undergoing chemotherapy who developed severe infection after pushing prolapsed hemorrhoids back in
- What they received
- conservative treatment: antibiotics, blood/immune support, and multimodal wound care including traditional Chinese medicine
- Compared with
- no comparator (single case)
- Main outcome
- resolution of fever, perianal infection, and hemorrhoid healing
- Quality
- this is a single patient case report, so it cannot reliably show whether manual reduction of hemorrhoids is safe or effective in general.
- Limitations
- single case report in a severely immunocompromised cancer patient; multiple simultaneous treatments make it impossible to know what helped; manual reduction itself led to an erosion and life-threatening infection in this case, not a planned safety study of the technique
Taken word for word from the abstract
- population
A 51-year-old female with stage IIIA human epidermal growth factor receptor 2-positive breast cancer developed a high fever (40.1°C) 1 week after her first cycle of neoadjuvant TCHP
- intervention
broad-spectrum systemic antibiotics (meropenem, vancomycin, amikacin, amphotericin B sequentially), aggressive hematologic support (granulocyte colony-stimulating factor, blood transfusions), and meticulous multimodal local wound care
- comparator
This case report details a successful conservative, multimodal approach to this rare and critical scenario.
- primaryOutcome
After 30 days of treatment, the patient became afebrile, and her perianal swelling and inflammation completely resolved.
- result
The eroded hemorrhoid healed entirely, allowing for a successful transfer to a lower-level hospital for continued supportive care.
- n
A 51-year-old female with stage IIIA human epidermal growth factor receptor 2-positive breast cancer
Medicine (Baltimore) · PMID 42798126 · Read it on PubMed ↗
Gallo et al. 2026
Use of mesoglycan in the acute phase of hemorrhoidal disease, the aCute HaemORrhoidal MEsoglycan Study (CHORMES): A double-blind, randomized controlled trial
Drug reduced hemorrhoid prolapse symptoms, not manual reduction.Randomised trialLow qualityRelated question
52 people40 days treatment plus 30-day telephone follow-up
mesoglycan group had a significantly larger drop in symptom score than placebo, with reductions in itching, pain, and swelling/prolapse
- Who was studied
- adults with symptomatic grade II to III hemorrhoid disease
- What they received
- oral mesoglycan taken daily for 40 days
- Compared with
- placebo
- Main outcome
- change in hemorrhoid symptom score (pain, itching, bleeding, swelling/prolapse) from baseline to day 40
- Quality
- small phase 2 trial of only 52 patients, and it tests a drug for symptoms rather than directly testing a manual reduction technique for prolapse.
- Limitations
- small sample size; this is a phase 2 trial; it studies an oral drug treatment, not a physical/manual reduction technique for prolapse.
Taken word for word from the abstract
- n
Fifty-two patients were randomized (26 mesoglycan, 26 placebo), and 48 completed the study.
- population
enrolled adults with symptomatic grade II to III hemorrhoidal disease
- intervention
Participants were randomly assigned (1:1) to receive oral mesoglycan or placebo for 40 days
- comparator
receive oral mesoglycan or placebo for 40 days
- primaryOutcome
The primary endpoint was the change in the Hemorrhoidal Disease Symptom Score from baseline to day 40.
- result
mesoglycan resulted in a significantly greater reduction in Hemorrhoidal Disease Symptom Score compared with placebo (-7.5 ± 5.9 vs -3.9 ± 5.4; P = .027)
- result
Symptom-specific analysis showed significant reductions in itching (P = .0048), pain (P = .0246), and swelling/prolapse (P = .0418) in the mesoglycan group.
Surgery · PMID 42442141 · Read it on PubMed ↗
Qureshi et al. 2026
AGA Clinical Practice Update on Diagnosis and Treatment of Hemorrhoids: Expert Review
Doesn't address pushing it back in.GuidelineLow qualityRelated question
size not given2026
Rubber band ligation has longer-term benefits for treatment of prolapsing hemorrhoids and recurrent bleeding, but the abstract does not describe manual reduction of a prolapsed hemorrhoid.
- Who was studied
- patients with hemorrhoids, including those with prolapse
- What they received
- treatments for hemorrhoids such as banding, infrared coagulation, topical agents and surgery
- Compared with
- surgical hemorrhoidectomy for grades 1 to 3 hemorrhoids
- Main outcome
- long-term treatment success for prolapsing hemorrhoids and recurrent bleeding
- Quality
- These are expert opinion best-practice statements without a systematic review or formal quality rating, so they carry limited evidentiary weight.
- Limitations
- Because systematic reviews were not performed, these BPA statements do not carry formal ratings regarding the quality of evidence or strength of the presented considerations.
Taken word for word from the abstract
- population
Hemorrhoids are a common problem.
- intervention
Both hemorrhoid banding and infrared coagulation are safe, effective, and easy to perform in the office setting.
- comparator
Hemorrhoid banding or infrared coagulation should be employed prior to surgical hemorrhoidectomy for grades 1 to 3 hemorrhoids.
- primaryOutcome
Rubber band ligation has longer-term benefits for treatment of prolapsing hemorrhoids and recurrent bleeding.
- result
Rubber band ligation has longer-term benefits for treatment of prolapsing hemorrhoids and recurrent bleeding.
- limitations
Because systematic reviews were not performed, these BPA statements do not carry formal ratings regarding the quality of evidence or strength of the presented considerations.
Clin Gastroenterol Hepatol · PMID 42067175 · Read it on PubMed ↗
Huang et al. 2026
Evaluation of short-term outcomes of Endoscopic Super-Hemorrhoidal Banding for mixed hemorrhoids with prolapsed internal hemorrhoids: a retrospective study
Similar cure, less pain and recovery timeRetrospectiveLow qualityRelated question
480 people2026
similar cure rates between the two treatments, but the banding procedure had shorter surgery and hospital stay, less pain, and fewer urinary retention complications
- Who was studied
- adults with mixed hemorrhoids and grade II-IV internal hemorrhoid prolapse
- What they received
- endoscopic band repositioning of the prolapsed hemorrhoid tissue (ESHB)
- Compared with
- standard surgical hemorrhoid removal (Milligan-Morgan hemorrhoidectomy)
- Main outcome
- cure rate, operative time, hospital stay, pain scores, and complications
- Quality
- this was a retrospective (non-randomized) comparison with only short-term follow-up, so it can't rule out bias and doesn't show long-term results
- Limitations
- retrospective design, short-term follow-up only, long-term efficacy not yet validated
Taken word for word from the abstract
- population
patients with mixed hemorrhoids treated in our hospital from June 2021 to June 2024
- intervention
Endoscopic Super-hemorrhoidal Banding (ESHB)
- comparator
Milligan-Morgan hemorrhoidectomy (MMH)
- primaryOutcome
Treatment outcomes included efficacy measurement, operative time, hospital stay, postoperative anal pain scores, and incidence of complications like bleeding and urinary retention were compared.
- result
The cure rates were 69.36% in the ESHB group and 72.65% in the MMH group, with no statistically significant difference between the two groups (P > 0.05). The observation group had significantly shorter operative time and hospital stay (P < 0.01), lower postoperative anal pain scores and incidence of urinary retention (P < 0.01).
- n
245 patients underwent Milligan-Morgan hemorrhoidectomy (MMH) and 235 patients underwent ESHB.
BMC Surg · PMID 41987169 · Read it on PubMed ↗
Drezdzon et al. 2023
Anorectal Emergencies
General review, no specific results given.Narrative reviewVery low qualityRelated question
size not given2023
most patients can be managed without surgery, but some conditions like gangrenous prolapse need surgery
- Who was studied
- people with anorectal emergencies including incarcerated hemorrhoids and rectal prolapse
- What they received
- bedside procedures and nonoperative management
- Compared with
- surgical management
- Main outcome
- diagnosis and management approach for anorectal emergencies
- Quality
- this is a general review describing management approaches without specific data or outcomes for reducing a prolapsed hemorrhoid
- Limitations
- no specific data, numbers, or outcome results reported; abstract only lists topics covered
Taken word for word from the abstract
- population
Anorectal emergencies are rare presentations of common anorectal disorders
- intervention
most patients presenting with anorectal emergencies can be managed nonoperatively or with a bedside procedure
- comparator
surgeons must also be able to identify surgical anorectal emergencies, such as gangrenous rectal prolapse
- primaryOutcome
workup, diagnosis, and management of common anorectal emergencies including thrombosed hemorrhoids, incarcerated hemorrhoids, anal fissure, anorectal abscess, rectal prolapse, and pilonidal abscess
- result
most patients presenting with anorectal emergencies can be managed nonoperatively or with a bedside procedure
Surg Clin North Am · PMID 37838461 · Read it on PubMed ↗
Yang et al. 2022
Modified ligation procedure for prolapsed haemorrhoids versus stapled haemorrhoidectomy for the management of symptomatic haemorrhoids (MoLish): randomized clinical trial
Compares two surgeries, not manual reduction.Randomised trialModerate qualityRelated question
133 people6 months
the modified ligation surgery took longer but caused less pain, less temporary incontinence, lower symptom scores, and a higher cure rate at 6 months than stapled surgery
- Who was studied
- adults with symptomatic hemorrhoids needing surgery
- What they received
- modified ligation procedure for prolapsed hemorrhoids (a surgical technique)
- Compared with
- stapled hemorrhoidectomy (another surgical technique)
- Main outcome
- how well the treatment worked, measured 6 months after surgery
- Quality
- it was a randomized trial but done at one center with some patients lost to follow-up, and it compares two surgeries rather than answering whether a prolapse can be manually pushed back in.
- Limitations
- single-center trial, two patients lost to follow-up, and it studies two surgical procedures rather than manual reduction of a prolapsed hemorrhoid
Taken word for word from the abstract
- n
133 patients were randomized (67 for MLPPH and 66 for SH)
- population
patients with symptomatic haemorrhoids
- intervention
modified ligation procedure for prolapsed haemorrhoids (MLPPH)
- comparator
stapled haemorrhoidectomy (SH)
- primaryOutcome
The primary outcome was the assessment of efficacy at 6 months after the intervention.
- result
The mean operating time was longer in MLPPH than in SH (57.42 min versus 30.68 min; P < 0.001). The median pain score was higher in SH than in MLPPH at postoperative day 3 (P = 0.018), day 7(P = 0.013), and day 14 (P = 0.003).
- result
The 6-month cure rate was higher in MLPPH than in SH (P = 0.003).
BJS Open · PMID 35552375 · Read it on PubMed ↗
What actually helps, on this site
More about the condition:
All 20 studiesEvery study that answered the question, with its design, size and result.
The other 14 studiesEverything else the search returned, including anything retracted.
Zu et al. 2026
Endoscopic rubber band ligation, injection sclerotherapy, and sclerobanding for the treatment of internal hemorrhoids
Combined scar-and-band treatment reduced recurrence and pain.RetrospectiveLow qualityRelated question
201 people24 months
combined sclerobanding had lower recurrence and less pain than sclerotherapy or banding alone for grade II-III hemorrhoids, with no difference for grade I
- Who was studied
- patients with grade I-III internal hemorrhoids treated endoscopically
- What they received
- endoscopic treatments for internal hemorrhoids: rubber band ligation, injection sclerotherapy, or combined sclerobanding
- Compared with
- the three endoscopic treatment methods compared against each other
- Main outcome
- clinical efficacy, recurrence rates, and postoperative adverse events
- Quality
- This is a retrospective study comparing treatment groups rather than a randomized trial, so differences could be due to other factors.
- Limitations
- Retrospective cohort design; comparison is between different endoscopic treatments, not about manual reduction of a prolapsed hemorrhoid.
Taken word for word from the abstract
- n
This retrospective cohort study was performed on 201 patients
- population
treating grade I-III internal hemorrhoids
- intervention
endoscopic rubber band ligation (ERBL), injection sclerotherapy (IS), and endoscopic polidocanol sclerobanding (ESB)
- comparator
grouped according to their endoscopic treatment (ERBL, IS, and ESB groups)
- primaryOutcome
The study analyzed clinical efficacy, short-term and overall recurrence rates, and postoperative adverse events.
- result
For grade II-III hemorrhoids, ESB possesses the dual advantages of lower recurrence rates and reduced postoperative pain compared with IS and ERBL.
- result
No significant difference was found in grade I hemorrhoids.
- followUp
with the longest follow-up extending to 24 months
World J Gastroenterol · PMID 41693967 · Read it on PubMed ↗
Hua et al. 2025
Transverse incision with longitudinal ligation procedure: Innovation, pitfalls, and clinical perspectives
New surgery had fewer short-term complications.Narrative reviewVery low qualityRelated question
size not given2025
TILL showed less pain, quicker healing, and lower risk of anal stenosis than Milligan-Morgan surgery
- Who was studied
- people with prolapsed hemorrhoids that go all the way around the anus
- What they received
- a new surgical technique called transverse incision with longitudinal ligation (TILL)
- Compared with
- traditional Milligan-Morgan hemorrhoidectomy surgery
- Main outcome
- short-term results including pain, healing speed, and anal narrowing
- Quality
- This is a commentary letter about a single small retrospective study with short follow-up, not new direct evidence.
- Limitations
- The abstract itself states the original study was retrospective, single-center, had a small sample size, and short follow-up, limiting generalizability and assessment of long-term outcomes like recurrence.
Taken word for word from the abstract
- population
circumferential prolapsed hemorrhoids
- intervention
transverse incision with longitudinal ligation (TILL) procedure is a new method for treating circumferential prolapsed hemorrhoids
- comparator
traditional Milligan-Morgan hemorrhoidectomy
- primaryOutcome
better than the traditional Milligan-Morgan hemorrhoidectomy for short-term results, showing less pain, quicker healing, and lower risk of anal stenosis
- result
TILL to be better than the traditional Milligan-Morgan hemorrhoidectomy for short-term results, showing less pain, quicker healing, and lower risk of anal stenosis
- limitations
the study's limitations, including its retrospective, single-center design, small sample size, and short follow-up, restrict the findings' generalizability and ability to assess long-term outcomes like recurrence
World J Gastroenterol · PMID 41480327 · Read it on PubMed ↗
Suzuki 2025
Combined therapy of HIFU rectoanal lifting (HIFU-RAL) and sclerotherapy for prolapsed hemorrhoids and rectal mucosal prolapse: A case series
Prolapse reduced, no recurrence seen.Case seriesVery low qualityRelated question
10 peoplemedian: 16.0 months; interquartile range: 10.5-25.8 months
all cases showed visible reduction or resolution of prolapse immediately after procedure, with no adverse events or recurrences during follow-up
- Who was studied
- patients with prolapsed hemorrhoids or rectal mucosal prolapse causing discomfort
- What they received
- combined HIFU rectoanal lifting (HIFU-RAL) and ALTA sclerotherapy injection
- Compared with
- none (single-arm case series, compared to before treatment)
- Main outcome
- visible reduction or resolution of prolapsed lesions and recurrence over follow-up
- Quality
- This is a tiny uncontrolled case series of only 10 patients with no comparison group, so it cannot reliably show the treatment works better than other options.
- Limitations
- Very small sample size, no control or comparator group, single case series design.
Taken word for word from the abstract
- n
This case series included 10 symptomatic patients, consisting of 5 men and 5 women.
- population
Clinical examination identified 8 cases of prolapsed hemorrhoids (Goligher grade III-IV) and 2 cases of rectal mucosal prolapse.
- intervention
we applied a transanal high-intensity focused ultrasound (HIFU) technique, namely HIFU rectal lifting (HIFU-RAL), combined with aluminum potassium sulfate and tannic acid (ALTA) sclerotherapy for treating prolapsed hemorrhoids
- comparator
The combined efficacy of HIFU-RAL and ALTA sclerotherapy was evaluated over time.
- primaryOutcome
In all cases, the prolapsed lesions were visibly reduced or resolved immediately after the procedure.
- result
During the follow-up period (median: 16.0 months; interquartile range: 10.5-25.8 months), no adverse events or recurrences were observed.
Medicine (Baltimore) · PMID 40922264 · Read it on PubMed ↗
Schwandner 2025
[Hemorrhoidal disease and stage-dependent treatment (including anal prolapse)]
Acute prolapse treated conservatively, not surgery.Narrative reviewLow qualityRelated question
size not given2025
treatment choice depends on disease stage; acute anal prolapse is managed conservatively and topically
- Who was studied
- people with hemorrhoidal disease at various stages
- What they received
- stage-based treatment of hemorrhoids (conservative, interventional, or surgical)
- Compared with
- different treatment stages/options compared to each other
- Main outcome
- symptom control and long-term prevention of recurrence
- Quality
- this is a general review describing treatment approaches rather than presenting original trial data on outcomes.
- Limitations
- abstract does not report specific study data, patient numbers, or comparative outcome results for reducing prolapse.
Taken word for word from the abstract
- population
The treatment of hemorrhoidal disease is carried out depending on the symptoms and stage of the disease.
- intervention
The treatment of hemorrhoidal disease is carried out depending on the symptoms and stage of the disease.
- comparator
"conventional" hemorrhoidectomy procedures are increasingly in competition with minimally invasive techniques (e.g. hemorrhoidal artery ligation, laser hemorrhoidoplasty, radiofrequency ablation)
- primaryOutcome
The ultimate goal of all treatment strategies for hemorrhoidal disease is symptom control and long-term absence of recurrence.
- result
In cases of acute anal prolapse, a conservative and topical approach is indicated.
Chirurgie (Heidelb) · PMID 40586790 · Read it on PubMed ↗
Schiano di Visconte 2025
Comparative efficacy of lidocaine- and nifedipine-based conservative therapies in acute hemorrhoidal disease: A retrospective cohort study
Lidocaine cream eased pain faster.RetrospectiveLow qualityRelated question
123 people21 days
the lidocaine-based treatment reduced pain and symptom scores faster than the nifedipine-based treatment, especially by day 7
- Who was studied
- adults with acute hemorrhoidal disease treated at a hospital
- What they received
- oral diosmin/hesperidin plus bromelain plus topical lidocaine cream
- Compared with
- oral diosmin/hesperidin plus bromelain plus topical nifedipine cream
- Main outcome
- symptom scores for pain and hemorrhoid severity over 21 days
- Quality
- this was a retrospective chart review without randomization or blinding, so differences between groups could be due to other factors.
- Limitations
- retrospective design, single center, no mention of randomization or blinding, short follow-up
Taken word for word from the abstract
- design
This retrospective study evaluates two treatment regimens for AHD
- n
Medical records of 123 patients with AHD treated at a tertiary care center between October 2022 and October 2024 were reviewed.
- population
patients with AHD treated at a tertiary care center
- intervention
Group A treated with oral diosmin/hesperidin, bromelain, and topical lidocaine
- comparator
Group B treated with oral diosmin/hesperidin, bromelain, and topical nifedipine
- primaryOutcome
Symptoms were evaluated using the Hemorrhoidal Disease Symptom Score (HDSS), Visual Analog Scale (VAS) for pain, and Short Health Scale for Hemorrhoidal Disease (SHS-HD) at baseline and on days 7, 14, and 21.
- result
Group A demonstrated faster pain reduction (VAS day 7:0.17 ± 0.52 vs. 2.20 ± 1.11, p < 0.001) and greater improvement in HDSS score (day 7: 0.02 ± 0.87 vs. 10.16 ± 3.38, p < 0.001).
- followUp
baseline and on days 7, 14, and 21
Surgeon · PMID 40581544 · Read it on PubMed ↗
Xu et al. 2025
Clinical Efficacy of Automatic Ruiyun Procedure for Hemorrhoids and Procedure for Prolapse and Hemorrhoids in the Treatment of Mixed Hemorrhoids: A Comparative Study
Not about manual reduction; compares two surgeries.RetrospectiveLow qualityRelated question
120 people12th week
RPH had shorter surgery time, less blood loss, less pain, shorter hospital stay, lower cost, and better quality of life scores than PPH; no significant difference in fecal incontinence scores or readmission rates
- Who was studied
- patients with mixed hemorrhoids
- What they received
- Ruiyun procedure for hemorrhoids (RPH), a type of hemorrhoid surgery
- Compared with
- procedure for prolapse and hemorrhoids (PPH), another type of hemorrhoid surgery
- Main outcome
- surgical time, pain, blood loss, hospital stay, cost, quality of life, complications, and readmission after surgery
- Quality
- This is a retrospective study from one hospital comparing two surgical techniques, which does not address manual reduction of a prolapsed hemorrhoid at all.
- Limitations
- Retrospective design, single center, and the study compares two surgical procedures rather than non-surgical manual reduction techniques.
Taken word for word from the abstract
- population
patients with mixed hemorrhoids who visited the Third Affiliated Hospital of Gansu University of Chinese Medicine
- intervention
automatic Ruiyun procedure for hemorrhoids
- comparator
procedure for prolapse and hemorrhoids
- n
60 cases were grouped under the Ruiyun procedure for hemorrhoids (RPH) group, and the other 60 cases were categorized in the procedure for prolapse and hemorrhoids (PPH) group
- primaryOutcome
Surgical time, intraoperative blood loss, duration of postoperative pain, length of hospital stay and hospitalization expenses between the two groups presented statistically significant differences
- result
RPH outperforms PPH in the treatment of mixed hemorrhoids with a shortened surgical time
- result
There was no difference in Vaizey's Fecal Incontinence Rating Scale score between the RPH group and the PPH group at the 12th week of follow-up (p > 0.05)
- followUp
at the 12th week of follow-up
Ann Ital Chir · PMID 39957120 · Read it on PubMed ↗
Sapkota Upadhya et al. 2024
Efficacy and Safety of Colonoscopic Band Ligation for Lower Gastrointestinal Bleeding due to Hemorrhoid
Band ligation relieved hemorrhoid bleeding and prolapse.Case seriesLow qualityRelated question
28 people3 months
symptoms of irritation, discharge and pain resolved in all patients by 3 months, bleeding resolved in 96.4% and prolapse in 92%, with complications in 53.5% of cases
- Who was studied
- patients with lower gastrointestinal bleeding caused by hemorrhoids (grade II)
- What they received
- colonoscopic rubber band ligation of hemorrhoids
- Compared with
- none (no comparison group)
- Main outcome
- resolution of bleeding, prolapse, irritation, discharge and pain, and patient satisfaction
- Quality
- This is a small single-group case series with no comparison group and only short follow-up, so it can't reliably show how well the treatment works compared to other options.
- Limitations
- Single-center study, no control group, over half of patients had post-procedure complications, and only short-term follow-up was reported.
Taken word for word from the abstract
- n
We included 28 among 108 patients presenting to the surgical outpatient department with Lower gastrointestinal bleeding.
- population
treatment of symptomatic grade II hemorrhoids
- intervention
Colonoscopic Rubber band ligation
- comparator
Colonoscopic Rubber band ligation provides enhanced visualization and maneuverability, improving safety and efficacy of Rubber band ligation compared to traditional Rubber band ligation methods.
- primaryOutcome
Symptoms of irritation, discharge, pain resolved in all patients at 3 months and that of bleeding and prolapse in 96.4% and 92% respectively.
- result
Post-procedure complications were reported in 53.5% of cases. 78.6% of patients rated Colonoscopic Rubber band ligation treatment as "excellent help".
J Nepal Health Res Counc · PMID 39923169 · Read it on PubMed ↗
Mou et al. 2024
Endoscopic polidocanol foam sclerobanding for treatment of internal hemorrhoids: A novel outpatient procedure
New hemorrhoid procedure, benefit still unconfirmed.Narrative reviewVery low qualityRelated question
size not given2024
EFSB is a novel therapy for internal hemorrhoids, but future studies with a larger sample, multiple treatment sessions, and long-term follow-up are required to confirm these findings
- Who was studied
- patients with grades II and III internal hemorrhoids
- What they received
- endoscopic polidocanol foam sclerobanding (EFSB)
- Compared with
- endoscopic rubber band ligation (ERBL)
- Main outcome
- prolapse recurrence and post-procedural pain
- Quality
- This is a commentary discussing another study rather than original research, so it offers no independent data to judge safety or efficacy.
- Limitations
- The abstract itself states that larger samples, multiple treatment sessions, and longer follow-up are needed to confirm findings.
Taken word for word from the abstract
- population
patients with grades II and III internal hemorrhoids with one-year follow-up
- intervention
Endoscopic polidocanol foam sclerobanding (EFSB)
- comparator
Endoscopic rubber band ligation (ERBL)
- primaryOutcome
long-term relief from prolapse recurrence and reduced 24-h post-procedural pain
- result
Results showed that EFSB is a novel therapy for internal hemorrhoids, but future studies with a larger sample, multiple treatment sessions, and long-term follow-up are required to confirm these findings.
World J Gastroenterol · PMID 39563748 · Read it on PubMed ↗
Akinmoladun et al. 2024
Management of Hemorrhoids and Anal Fissures
No specific answer givenNarrative reviewVery low qualityRelated question
size not given2024
The abstract does not report specific results on manually reducing a prolapsed hemorrhoid; it is a general overview of diagnosis and treatment options.
- Who was studied
- people with hemorrhoids or anal fissures
- What they received
- medical and surgical treatment options for hemorrhoids and anal fissures
- Quality
- This is a general narrative review that does not report specific data, methods, or results on manual reduction of prolapsed hemorrhoids.
- Limitations
- The abstract gives no specific information about manual reduction technique, safety, or outcomes; it is a broad overview of hemorrhoid and fissure management.
Taken word for word from the abstract
- population
Hemorrhoids and anal fissures are two of the most common benign anorectal diseases.
- intervention
numerous medical and surgical treatment options are available, each with different rates of success and complications
- result
The article discusses the pathophysiology, diagnosis, medical management, and procedures for hemorrhoids followed by a detailed overview on the management of anal fissures.
Surg Clin North Am · PMID 38677814 · Read it on PubMed ↗
Fathallah et al. 2024
Hemorrhoidal disease: Epidemiological study and analysis of predictive factors for surgical management
Surgery gave better symptom relief and satisfaction.Prospective cohortLow qualityRelated question
472 people2024
bleeding and prolapse scores improved significantly after treatment, with greater improvement and higher satisfaction in the surgery group (73% vs 54% very good satisfaction)
- Who was studied
- patients with hemorrhoidal disease seeking care
- What they received
- medical, instrumental, or surgical treatment for hemorrhoids
- Compared with
- different treatment modalities compared with each other (medical vs instrumental vs surgical)
- Main outcome
- change in bleeding and prolapse scores and patient satisfaction after treatment
- Quality
- This is a single-center observational study without randomization, so differences between treatment groups could be due to patient selection rather than treatment itself.
- Limitations
- Single-center, non-randomized, patients not randomly assigned to treatment groups, so comparisons between medical, instrumental, and surgical treatment may be biased by underlying differences in disease severity.
Taken word for word from the abstract
- n
Prospective single-center study from July to December 2021 including 472 patients.
- population
Bleeding, prolapse and pain were the main reasons for consultation.
- intervention
Treatment modalities were medical (44%),±instrumental (72%), and surgical (17%).
- comparator
Treatment modalities were medical (44%),±instrumental (72%), and surgical (17%).
- primaryOutcome
After treatment, the bleeding score and prolapse score decreased significantly (P=0.002 and P≤0.0001, respectively), but improvement was more marked in the surgery group with a better rate of "very good satisfaction" (73% vs. 54%, P=0.003).
- result
improvement was more marked in the surgery group with a better rate of "very good satisfaction" (73% vs. 54%, P=0.003)
J Visc Surg · PMID 38580520 · Read it on PubMed ↗
Medkova et al. 2024
Thrombosed external hemorrhoids during pregnancy: surgery versus conservative treatment
Not about manual reduction of prolapse.Prospective cohortLow qualityRelated question
53 people10 days
Surgery gave faster pain relief and better quality-of-life scores by day 10 than conservative treatment; both were safe, and thrombectomy had a higher re-thrombosis rate than local excision
- Who was studied
- pregnant women with thrombosed external hemorrhoids
- What they received
- surgical treatment (local excision or thrombectomy) for thrombosed external hemorrhoids
- Compared with
- conservative treatment for thrombosed external hemorrhoids
- Main outcome
- pain and quality-of-life scores (VAS, CPGAS, SF-12) after treatment
- Quality
- This study is about surgical versus conservative treatment of thrombosed external hemorrhoids in pregnancy, not about manually pushing back a prolapsed hemorrhoid, so it does not answer the question asked.
- Limitations
- Only part of the study (the surgical subtypes) was randomized; the main conservative-vs-surgery comparison was observational, and randomization in the surgical arm was stopped early for ethical reasons.
Taken word for word from the abstract
- n
Fifty-three patients entered the study.
- population
pregnant women affected by TEH
- intervention
local excision (LE) versus thrombectomy (TE)
- comparator
Twenty-six patients had conservative treatment and 22 underwent surgery.
- primaryOutcome
The primary outcome measured was the impact of conservative and surgical treatment defined in terms of VAS, clinical patient grading assessment scale (CPGAS) and the SF-12 questionnaire.
- result
The surgical group showed an earlier significant reduction of pain on the 3rd day (p = 0.0004).
- result
Thrombectomy is associated with higher risk of re-thrombosis when compared to local excision
- followUp
VAS, SF-12 and CPGAS improved in both groups after 3 and 10 days from the treatment.
Updates Surg · PMID 38151682 · Read it on PubMed ↗
Anorectal Branch of Chinese Medical Doctor Association et al. 2023
[Chinese expert consensus on the treatment of hemorrhoids by injection(2023 edition)]
No info on manual reduction.GuidelineLow qualityRelated question
size not given2023
abstract does not report a quantitative outcome; it describes formation of expert consensus recommendations on types and application of injection treatments
- Who was studied
- adults with hemorrhoids, usually aged 25-65
- What they received
- injection therapy for hemorrhoids
- Main outcome
- expert recommendations on drug/dosage selection for hemorrhoid injection treatment
- Quality
- this is an expert consensus statement summarizing recommendations rather than a study with measured outcomes, so it carries limited direct evidence weight.
- Limitations
- abstract does not address manual reduction of prolapsed hemorrhoids; it focuses on injection therapy consensus, not mechanical repositioning technique or safety.
Taken word for word from the abstract
- population
usually occurring in middle-aged people aged 25-65 years old
- intervention
Injection therapy with a history of more than 150 years is simple to operate, easy to popularize and apply in grass-roots units
- result
form the Chinese Expert Consensus on the Treatment of hemorrhoids by anal injection (2023 edition), aiming to guide the reasonable selection of drugs and dosage forms for hemorrhoidal injection treatment
- primaryOutcome
make detailed recommendations on the types and application methods of the preparations commonly used in the injection treatment of hemorrhoids
Zhonghua Wei Chang Wai Ke Za Zhi · PMID 38110270 · Read it on PubMed ↗
Fiordaliso et al. 2023
Treatment of haemorrhoids in pregnancy: A retrospective review
Reviews general hemorrhoid care in pregnancy.Systematic reviewLow qualityRelated question
size not given2023
review summarizes that fiber, stool softeners and mild laxatives are generally safe, topical or oral treatments need caution, anal packing can help with bleeding, and surgery is reserved for severe cases
- Who was studied
- pregnant women with hemorrhoids
- What they received
- various treatments for hemorrhoids in pregnancy (fiber, stool softeners, topical meds, anal packing, surgery)
- Main outcome
- appropriate management approach for hemorrhoids during pregnancy
- Quality
- This is a narrative-style literature review without quality grading or statistical pooling, so its conclusions are weak evidence.
- Limitations
- No formal quality assessment, no mention of manual reduction technique for prolapsed hemorrhoids, and no numeric patient data reported.
Taken word for word from the abstract
- population
Haemorrhoids are common in young women and commoner during pregnancy and the puerperium.
- intervention
Fiber supplement, stool softener and mild laxatives are generally safe for pregnant women.
- intervention
Topical medication or oral phlebotonics may be used with special caution
- intervention
In case of massive bleeding, anal packing could be a simple and useful maneuver.
- intervention
Hemorrhoidectomy is reserved in strangulated or extensively thrombosed hemorrhoids, and hemorrhoids with intractable bleeding.
- primaryOutcome
we address the issue of the approach of the obstetrician and surgeons to haemorrhoids and their management
- result
Fiber supplement, stool softener and mild laxatives are generally safe for pregnant women. Topical medication or oral phlebotonics may be used with special caution because the strong evidence of their safety and efficacy in pregnancy is lacking. In case of massive bleeding, anal packing could be a simple and useful maneuver. Hemorrhoidectomy is reserved in strangulated or extensively thrombosed hemorrhoids, and hemorrhoids with intractable bleeding.
Ann Ital Chir · PMID 37530049 · Read it on PubMed ↗
Zhongguo Zhong Yao Za Zhi 2022
[Expert consensus on clinical application of Fufang Jingjie for Fumigation and Washing]
Expert guidance, not about manual reduction.GuidelineVery low qualityRelated question
size not given2022
The consensus describes the drug's functions and gives guidance on usage, dosage, adverse reactions and precautions, but does not report a measured clinical outcome or data on manually reducing a prolapsed hemorrhoid
- Who was studied
- people with anal diseases such as hemorrhoids, prolapse, fissures and abscesses
- What they received
- Fufang Jingjie for Fumigation and Washing, a traditional Chinese medicine topical wash/fumigation treatment
- Main outcome
- expert recommendations on usage, dosage and safety rather than a measured clinical outcome
- Quality
- This is an expert opinion/consensus statement based on literature review and clinical experience, not a controlled study with measured outcomes.
- Limitations
- No study design, no patient numbers, no comparator, and no outcome data are reported; it is an opinion-based consensus rather than original research, and it does not address manual reduction technique.
Taken word for word from the abstract
- population
widely used for the treatment of external hemorrhoids, mixed hemorrhoids, internal hemorrhoids prolapse and incarceration, anal fissures, perianal abscess, anal fistula acute attack, perianal eczema and other diseases
- intervention
Fufang Jingjie for Fumigation and Washing is one of the commonly used and effective drugs for external fumigation and washing of traditional Chinese medicine
- primaryOutcome
the function, usage, dosage, adverse reactions and points for attention were discussed of Fufang Jingjie for Fumigation and Washing
- result
This consensus was formed to provide reference for the clinical application of Fufang Jingjie for Fumigation and Washing.
Zhongguo Zhong Yao Za Zhi · PMID 36472015 · Read it on PubMed ↗
How we searchedThe exact query, the date it ran, and what came back — so you can run it yourself.
- Searched
- PubMed · ClinicalTrials.gov · Crossref on 2026-10-13
- The exact search — paste this into PubMed to repeat it
"Hemorrhoids"[Mesh] AND (prolapse*[tiab] OR "manual reduction"[tiab] OR reduc*[tiab] OR incarcerat*[tiab] OR strangulat*[tiab] OR thrombos*[tiab])- PubMed expanded that to:
"Hemorrhoids"[MeSH Terms] AND ("prolapse*"[Title/Abstract] OR "manual reduction"[Title/Abstract] OR "reduc*"[Title/Abstract] OR "incarcerat*"[Title/Abstract] OR "strangulat*"[Title/Abstract] OR "thrombos*"[Title/Abstract]) - What came back
- 1436 records found · 200 read · 20 answered the question
- Included
- Human, animal or laboratory studies reporting an outcome relevant to the question
- Excluded
- Records about a different condition or intervention
- Records reporting no outcome
- Retracted publications, which are listed but excluded from every count
- Limits
- Details were read from abstracts, not full papers, so anything reported only in a paper's methods section is not captured here.
- Fields were read from abstracts, not full text, so detail reported only in a paper's methods section is not captured.
- Evidence strength is adapted from the GRADE framework. It is not a GRADE assessment and was not produced by a GRADE panel.
Automated evidence review — PubMed, ClinicalTrials.gov, Crossref. Search strategy, grading rules and the checks that must pass before anything publishes were written by Allen Kamrava, MD, MBA, FACS, FASCRS, colon & rectal surgery, Beverly Hills. The pages themselves are compiled by software running that method and are not read one by one before publication — saying otherwise would be the one claim here that could not be checked.
- 1436records came back from the search
- 200were read
- 20actually answered the question
Risks and safetyReported side effects and who should be careful.
- Reviews of anorectal emergencies note that a prolapse that cannot be reduced and becomes strangled or gangrenous needs emergency surgery, though no study tested whether manual reduction attempts help prevent or accidentally worsen this.
Common questionsShort answers, drawn from the same studies.
- Can you push a hemorrhoid back in with your finger?
- No study has tested whether doing this is safe or effective. One case report describes someone who pushed a prolapsed hemorrhoid back in and developed a serious infection, though she had a weakened immune system from cancer chemotherapy at the time.
- How far do you push a hemorrhoid back in?
- No study gives a distance or technique for this, so there is no evidence-based answer to how far is enough or too far. If a hemorrhoid will not go back in easily, forcing it is not supported by any research and a doctor should look at it instead.
- What's the best position to push a hemorrhoid back in?
- No study has compared positions for doing this, so there is no research-backed answer. This has simply not been tested.
- Do hemorrhoids come back after being pushed back in?
- No study followed people after manual reduction to see if prolapse returns. Studies of other treatments, like banding and surgery, do track recurrence over months, and recurrence does happen with those methods too, but that is a different situation.
- Why do hemorrhoids keep coming back?
- The studies found do not test the causes of recurrence after manual reduction specifically. They do show that even after banding or surgical procedures, some prolapse or hemorrhoid tissue can return, which suggests the underlying tissue changes are not always fully fixed by any single treatment.
This is information, not advice
This page summarises published research. It cannot tell you what is happening in your own body, and evidence changes. If something is bleeding, painful, or new, it is worth being looked at — that is a different question from the one on this page, and a better one to bring to a consultation.
Contact the officeAutomated evidence review — PubMed, ClinicalTrials.gov, Crossref. Search strategy, grading rules and the checks that must pass before anything publishes were written by Allen Kamrava, MD, MBA, FACS, FASCRS, colon & rectal surgery, Beverly Hills. The pages themselves are compiled by software running that method and are not read one by one before publication — saying otherwise would be the one claim here that could not be checked.