What is the ruling on ritual purity when one is unable to determine whether hemorrhoids have protruded?

If you suffer from سلس ( سلس البول or سلس الريح - urinary or fecal incontinence, or continuous passing of gas), then perform ablution (Wudu') for each prayer after its time has begun, and pray the obligatory prayer (Fard) and as many supererogatory prayers (Nawafil) as you wish until that time expires. However, if you do not suffer from سلس, then perform ablution after something exits (that invalidates Wudu') if you intend to pray. You are not required to perform ablution due to doubt; rather, perform ablution only if you are certain that something necessitating Wudu' has exited.