Welcome Good evening 1. By history of patient clinician can think of rectal prolapse without asking to strain or valsalva manauovre ... a. History of bulge/ mass/something coming out of anal opening at defecation or otherwise with or without following b. Discharge/Soiling c. Bleeding d. Pain in anal area. e. Investigations like EMG, MANOMETRY,  TRANS-RECTAL USG etc 2. On looking with light ,torch in this  case, Certainly one can diagnose prolapse rectum- red pink mass with concentric rings, sulcus on inspection. Thanks Regards

It’s it’s strangulated then yes, otherwise rectal prolapse is only diagnosed clinical by straining

Yes clinically by straining

Sometimes not visible from outside

Not by doing so, but it appears on straining