Draw a frontal section figure displaying these details. She describes 15 year of discomfort and swelling in the anal area following bowel motions.
Relief is achieved by finger pressure to move the swelling back into the anal canal.
Occasional blood spotting is observed on the toilet tissue. Suppositories have been tried with occasional benefit. Past medical history is notable for multiparity, G4P4. Physical exam of the abdomen is normal. The perianal area is normal in appearance.