What is rectal prolapse?

Rectal Prolapse

Rectal prolapse: Overview

A rectal prolapse happens when part or all of the wall of the rectum slides out of place and sticks out of the anus. It may be a partial prolapse, where only part of the lining of the rectum slides out of place. Or it may be a complete prolapse, where the entire wall of the rectum slides out of place.

Many things increase your chance of having a rectal prolapse. These include:

  • Straining during bowel movements.
  • Tissue damage from surgery or childbirth.
  • Weakness of pelvic floor muscles as people get older.

Your doctor may diagnose a rectal prolapse by asking questions about your symptoms and doing a rectal exam. Home treatment often helps the problem, but you may need surgery.

Rectal prolapse

A rectal prolapse happens when part or all of the wall of the rectum slides out of place, sticking out of the anus. It may be a:

  • Complete prolapse. The entire wall of the rectum slides out of place. At first, it may slip out of the anus only during bowel movements. Over time, this may occur when you stand or walk. And in some cases, the tissue may stick out of the anus all the time.
  • Partial prolapse. The lining (mucous membrane) of the rectum slides out of place. It may slip out of the anus when you strain to have a bowel movement.

Rectal prolapse is most common in older female adults. It sometimes occurs in young children. Many things increase the risk of rectal prolapse, but it may be hard to find the exact cause.

Treatment depends on the type of prolapse. It may involve changes in diet, medicines such as stool softeners, or surgery.

What are the symptoms of rectal prolapse?

At first, you may leak stool, mucus, or blood from the anus. Other symptoms include feeling that your bowel is full or that you can't completely empty your bowel. Or you may pass many very small stools or have anal pain, itching, irritation, and bleeding.

Types of Rectal Prolapse

Normal rectum and complete prolapse of rectum
Rectal prolapse: partial and internal

Rectal prolapse happens when loose tissue in the rectum slides downward. The loose tissue may partially or completely stick out of the anus.

There are three types of rectal prolapse:

  • Complete prolapse. Part of the wall of the rectum slides down and sticks out from the anus. At first, this may occur only during a bowel movement. In later stages, the prolapse may happen when the person stands or walks. Or it may stay outside the body all the time.
  • Partial prolapse (also called mucosal prolapse). Only the lining of the rectum slides down. The lining of the rectum usually comes out of the anus only when the person strains to have a bowel movement. Partial prolapse is most common in children younger than 2. A partial prolapse can sometimes be confused with hemorrhoids.
  • Internal prolapse. One part of the wall of the large intestine or rectum slides over another part of the rectum, like the folding parts of a toy telescope. The rectum does not protrude outside the anus. Internal prolapse is most common in children.

Treatment for rectal prolapse depends on the type of prolapse. Treatment may include changes in diet. Or it may include medicines or surgery.

How is rectal prolapse treated?

If a rectal prolapse doesn't improve with self-care, you may need surgery. Doctors may attach the rectum to the muscles of the pelvic floor or the lower end of the spine (sacrum). In some cases, they may also remove a section of the large intestine.

How is rectal prolapse diagnosed?

The doctor will ask questions about your symptoms and medical history and do a physical exam. This may include checking the rectum and the strength of the anal sphincter. You may need tests to rule out other conditions, such as a colonoscopy or a barium enema.

How can you care for yourself when you have a rectal prolapse?

Try to avoid constipation. Eat foods that are high in fiber, and drink plenty of fluids. Don't strain during bowel movements. Use a stool softener if needed. Try Kegel exercises to help strengthen the muscles of the pelvic area. Ask your doctor if it's okay to push the prolapse back into place.

What puts you at risk for rectal prolapse?

The exact cause is not clear, but many things increase the risk of rectal prolapse. These include straining during bowel movements because of constipation. Tissue damage caused by surgery or childbirth, or weak pelvic floor muscles due to aging, may also lead to rectal prolapse.

What is rectal prolapse?

In a rectal prolapse, all or part of the wall of the rectum slides out of place and slips out of the anus. Tissue may bulge out of the anus only during bowel movements. But over time, this may happen when you stand or walk, or it may stick out all the time.

How to push a rectal prolapse into place

You may be able to push a rectal prolapse back into place as soon as it occurs. Your doctor will let you know if this is okay to do.

  1. Put on disposable gloves, and put lubricating jelly on your finger.
  2. Gently push back any tissue that has come out of the anus.
  3. Apply an ice pack to help decrease swelling. Be sure to keep a damp cloth between your skin and the ice pack so that the cold doesn't damage the skin.

If the rectal tissue cannot be inserted easily into the anus, see your doctor.

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