###Human: My anal lining bulges out during defecation. Is it due to hemorrhoids or rectal prolapse? ###Assistant: Hi, Hope you are fine. 1) pain while defecating, and feeling of bulge, this is mostly a hemorrhoid, which sometimes could be associated with spot of blood on the toilet seat, and sometimes not. How to differentiate between a hemorrhoid and a rectal prolapse? to be examined by a surgeon, other wise it's difficult by history only. However, being young and healthy, it's unlikely to have a prolapse (it's a disease of elderly and anoreceptor intercourse). prolapse is usually completely circumferential, but hemorrhoids, usually one location (described as clockwise related 3,7,11 o'clock). 2) your abdominal pain, likely it's IBS, having intermittent diarrhea and constipation flavoring it. 3)- so to help ease your symptoms, we need to treat and fix your bowel habits, which is more fibers (green vegetables, avoid carbs), stool softener like Normacol (over the counter drug, which is basically fibers) 1 -2 sachet per day, till having soft easy stool. 4) part of IBS treatment, is psychological therapy, you need to relieve your stress, which will help you a lot with the diarrhea.