Although both rectal prolapse and prolapse of internal hemorrhoids involve swollen or foreign objects protruding from inside to outside the anus, the protruding object in the case of internal hemorrhoids is a congested, swollen hemorrhoid, generally petal-shaped. In contrast, the prolapsed rectal mucosa has distinctive radial or circular hooks. Secondly, the tightness of the anus in cases of internal hemorrhoid prolapse is generally normal, whereas in rectal prolapse, the tightness of the anus is usually loose.