This is a typical mixed hemorrhoid when a lump comes out of the anal opening during a bowel movement. If the lump comes out during defecation and then retracts into the anus after defecation, this is a second degree mixed hemorrhoid. If you have to push it back by hand after it comes out, it is a third degree mixed hemorrhoid, and if it stays outside the anal opening and does not go back, it is a fourth degree mixed hemorrhoid. The first and second degree of mixed hemorrhoids are recommended for internal conservative treatment, while the third and fourth degree are recommended for surgical treatment. The first thing you need to do is to soften your stool and not to dry it out; secondly, you need to make the mass retract inside the anus in time after it comes out; thirdly, reduce the defecation time, not more than three minutes at a time, and it is better to have a stool once a day; fourthly, avoid prolonged sitting and squatting and spicy stimulating food; fifthly, you can also use suppositories to be inserted into the anus to promote the absorption of the hemorrhoids. If this treatment does not relieve, you can consider surgery, mixed hemorrhoids external peeling internal ligation, or hemorrhoidal mucosal resection anastomosis.