Brief Answer:
hemorrhoid vs rectal prolapse

Detailed Answer:
Hello,
I can understand your concern on GI symptoms.
1) Protrusion of pinkish mucosa out from anus might be either hemorrhoid or partial rectal mucosal prolapse. Differentiation between these two can be done by physical examination only.
2) Hemorrhoid would prolapse outside only after attaining sufficient size and during straining only. It can be reduced back into anal canal and covered with skin partially or completely depending on type of hemorrhoid (Internal vs External).
3) Rectal mucosa prolapse also occur during straining but it would not be covered with overlying skin and can be reduced easily. Only complete prolapse will be difficult to reduce.
4) Yes. Generally hemorrhoid is associated with bright red blood. If sometimes quantity of blood is not much then clot remain stick to hemorrhoid bleeding site and turned into brown color due to chemical reaction with intestinal enzymes. Thus small previous episode of bleeding in intestine would be brown in color whereas bleeding in large quantity very near to anus would be bright red.
5) More characteristic of bleeding associated with anal pathology is that bleeding would be odourless and found either on toilet paper, on surface of stool, on undergarments. In bleeding from deep in intestine, it would be mixed with stool (dark brown colored stool) with typical odour.
6) You should consult general surgeon to differentiate these two condition and appropriate treatment must be started based on findings. Also you must take stool softener or laxatives to reduce straining which also reduce pain and chance of bleeding.

Hope I answered your query. If you have any further doubts, I would be happy to help you.
Have a good day!

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