What is rectal prolapse?
Rectal prolapse is a condition resulting from the weakening of the ligaments and muscles around the rectum, which causes the tissue lining the rectum and part of the large intestine to slip through the anal opening.
There are three types of rectal prolapse:
- Internal, or incomplete, prolapse: The rectum has prolapsed but not slipped through the anus.
- Mucosal prolapse: The interior lining of the rectum protrudes through the anus.
- External, or complete, prolapse: The full thickness of the rectum protrudes through the anus.
What causes rectal prolapse?
The exact causes of rectal prolapse are unknown, but chronic constipation, straining to pass bowel movements, weakened pelvic floor muscles and trauma can contribute.
Who is at risk for rectal prolapse?
Rectal prolapse is most common in young children and the elderly.
What are the symptoms of rectal prolapse?
Signs and symptoms of rectal prolapse can include:
- Pain and discomfort deep within the lower abdomen
- Blood and mucus from the anus
- The feeling of constipation or that the rectum is never completely emptied after bowel movements
- Difficulties passing a bowel movement
- Protrusion of the rectum through the anus
- The need to use a significant amount of toilet paper to clean up after a bowel movement
- Leakage feces
- Fecal incontinence
How is rectal prolapse diagnosed?
Rectal prolapse can usually be diagnosed by simple examination in the clinic.
To diagnose internal prolapse, a health care provider might administer tests that include ultrasound, X-rays and measurement of anorectal muscle activity, also known as anorectal manometry.
How is rectal prolapse treated?
Rectal prolapse can be treated through diet and lifestyle changes and surgery depending on the severity.
Rectal prolapse seldom responds to medical therapy in adults. Surgery will almost always be required to prevent long term complications, such as worsening fecal incontinence.
What are the possible complications of rectal prolapse?
Rectal prolapse complications can include:
- Risk of damage to the rectum, including ulceration and bleeding
- Strangulation of the rectum
- Death and decay (gangrene) of the strangulated section of the rectum
The primary complication of untreated rectal prolapse is worsening of the protrusion, increased discomfort, and worsening fecal incontinence. Prompt surgical evaluation is the best way to prevent permanent damage to nerves and muscles around the rectum.
Sources
- Rectal prolapse. (2014). https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/rectal-prolapse