Hi,
Welcome to health care magic,
This fat like hanging part could be prolapsed
internal hemorrhoids which needs to be examined by general surgeon to exactly diagnose the degree of its.
As you are already having external haemorroids it needs to be treated urgently.
Now,treatment of piles depends on its degree.
If it is 1st or 2nd degree piles then it can be managed conservatively means without surgery.
You might require topical steroids like anovate cream,
oral antibiotics (ofloxacin with ornidazole),antiinflammatory,antihistamines and laxatives or purgative (if
constipation) with other supportive treatment like hot seitz bath and avoid oily,spicy and non-veg diet with high intake of dietary fibers like salads.
If it is 3rd or 4th degree means partial or complete
rectal prolapse then surgery is the best way to get cured with all above conservative treatment.
Consult general surgeon for further advise.
Regards,