Rectal prolapse is the protrusion of the rectal mucosa, which manifests as an eversion of the mucosa presenting as pink-colored, cylindrical protrusions. These can usually be manually repositioned back into the anus, appearing smooth once repositioned. In contrast, external hemorrhoids are mostly caused by varicosities and are the same color as the skin. They cannot be completely repositioned manually, which distinguishes them from rectal prolapse.