Rectal Prolapse

If your diagnosis is a rectal prolapse, you know it's not just about physical discomfort. It's an emotional and psychological one as well. We want to help get you back to your daily activities, like walking or other activities that make you smile.

Rectal prolapse in adults is a rare condition occurring when some or all the tissue that lines the rectum slips out of the anus. It is most common in older women but can happen in men and women of all ages.

Causes of rectal prolapse

The most common cause of rectal prolapse is vaginal childbirth. This is particularly true for women who have had more than one baby delivered through the vagina. The stretching and pressure during childbirth weakens the female pelvic structure.

Other health conditions that can make rectal prolapse more likely include:

  • Long-term bowel problems such as constipation and straining during bowel movements or diarrhea
  • Problems in the pelvic area, including - weak muscles, a history of pelvic surgery or weakness due to age
  • Malnutrition
  • Physical developmental problems
  • Cystic fibrosis - a child who has rectal prolapse should be tested for cystic fibrosis

Symptoms of rectal prolapse

The main symptom is bright red tissue sticking out of the anus. The tissue might have mucus or blood on it. Rectal prolapse is not usually painful but can be uncomfortable. In most cases, the prolapse happens after a bowel movement. The tissue might stay outside the anus or it may move back inside the body on its own.

Other symptoms include:

  • Leaking of mucous or blood from the anus
  • Trouble starting a bowel movement (BM)
  • Feeling like you have not emptied your bowels after a BM or having small BMs
  • A feeling of full bowels and an urgent need to have a bowel movement
  • Leaking solid or liquid bowel movements (called “fecal incontinence”)
  • Anal itching, irritation, bleeding or pain

You should seek medical attention if the tissue is outside the anus and you are not able to push it back inside with your finger. You should also seek medical attention if there is bleeding from the area.

Testing for rectal prolapse

Your doctor or nurse should be able to tell if you have the problem by doing an exam. If the tissue has moved back inside your body, your doctor might ask you to squat or sit on the toilet. He or she will check to see if the tissue has come back out of your body.

You might need other tests. These tests can also show if you have a different problem. They include:

  • Cystocolpoproctography – A doctor fills your bladder, vagina, and rectum with a substance called “contrast material.” This allows these body parts to show up on X-rays and gives your doctor a veiw into how they are working.
  • Defecography – Contrast material is placed in the rectum. Care experts take X-rays while you have a bowel movement.
  • Manometry - A test that measures the pressure inside the rectum. It can show if the muscles that control bowel movements are working correctly.

Treatment for Rectal Prolapse

The treatment depends on how serious your symptoms are and if you have other health problems.

Your care team will discuss treatment options like:

  • Diet to avoid constipation - Eat foods that are high in fiber. Good choices are fruits, vegetables, prune juice, and grain cereal. You should eat between 25 to 30 grams of fiber per day. Drink 4 to 8 cups of water or other fluids per day. Laxative or enemas may be necessary as well.
  • Pelvic floor exercises with biofeedback - Exercises strengthen the muscles that control the flow of urine and bowel movements. They are “Kegel” exercises. Biofeedback uses devices called sensors that measure muscle activity. They can tell you if you are using the muscles the right way

Surgery for Rectal Prolapse

If you tried non-surgical treatments, like dietary changes, without success, surgery may be your best option. Surgery help if your diagnosis is either:

  • Complete prolapse, when the entire wall of the rectum slides outside the anus
  • Partial prolapse, only the inside lining of the rectum slides out the anus

The surgery is most often done through the abdomen. In some cases, it is done through the area between the genitals and the anus, called the “perineum.”

The purpose of the surgery is to secure the rectum to the muscles of the pelvic floor. Sometimes, surgery may also involve removing a segment of the colon or rectum. This will prevent it from sliding down through the anus.

Your doctor will discuss your options and your surgical risks with you if you need surgery.

Learn more about rectal prolapse.

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