What is rectal prolapse? What are the symptoms of rectal prolapse? What causes rectal prolapse? How is rectal prolapse diagnosed and treated? Discover the answers to these questions and more in this informative article.

Understanding Rectal Prolapse

Rectal prolapse is a medical condition where the rectum, the last section of the large intestine, slips or falls down from its normal position and protrudes through the anus. This can happen in three different forms: external prolapse, where the entire rectum sticks out; mucosal prolapse, where only part of the rectal lining pokes out; and internal prolapse, where the rectum has started to drop but is not yet visible outside the body.

Symptoms of Rectal Prolapse

The most common symptom of rectal prolapse is the feeling of a bulge or mass outside the anus, especially after a bowel movement. Other symptoms can include pain in the anus or rectum, bleeding, and leakage of stool, blood, or mucus. In the early stages, rectal prolapse may resemble hemorrhoids, but these are separate conditions that require different treatment.

Causes of Rectal Prolapse

There are several factors that can contribute to the development of rectal prolapse, including a long-term history of diarrhea or constipation, straining during bowel movements, old age, previous injuries to the anal or hip area, and neurological problems that affect muscle control. Women, especially those over 50, are more prone to developing rectal prolapse than men.

Diagnosing Rectal Prolapse

To diagnose rectal prolapse, your doctor will perform a physical examination, which may involve asking you to have a bowel movement while they observe. They may also order additional tests, such as anal electromyography (EMG), anal manometry, anal ultrasound, or imaging scans like proctography or colonoscopy, to get a better understanding of the underlying cause and severity of the condition.

Treatment Options for Rectal Prolapse

The treatment for rectal prolapse depends on the severity of the condition and the underlying cause. In mild cases, non-surgical treatments like dietary changes, pelvic floor exercises, or the use of a rectal support device may be sufficient. More severe cases may require surgical intervention to reposition the rectum and strengthen the pelvic floor muscles.

Preventing Rectal Prolapse

While there are no guaranteed ways to prevent rectal prolapse, maintaining a healthy diet, staying hydrated, and avoiding chronic constipation or straining during bowel movements can help reduce the risk. Seeking prompt medical attention for any issues with the rectum or bowel movements is also important to catch the condition early and prevent it from worsening.

Complications of Rectal Prolapse

If left untreated, rectal prolapse can lead to complications such as the rectum becoming stuck outside the body, leading to pain, bleeding, and potentially life-threatening infections. It can also cause incontinence, making it difficult to control bowel movements. Seeking prompt medical attention and following the recommended treatment plan is essential to prevent these complications and improve quality of life.

Is Rectal Prolapse a Medical Emergency?

Rectal prolapse is typically not considered a medical emergency, but the longer it goes untreated, the more severe the condition can become. If the prolapsed rectum cannot be manually pushed back in or if it becomes painful, swollen, or difficult to urinate, it may require immediate medical attention to prevent further complications.

How Common is Rectal Prolapse?

Rectal prolapse is a relatively uncommon condition, with an estimated prevalence of about 2.5 per 100,000 people in the general population. However, it is more common in older adults, especially women, and individuals with certain underlying health conditions that weaken the pelvic floor muscles or cause chronic straining during bowel movements.

Can Rectal Prolapse Be Prevented?

While there is no guaranteed way to prevent rectal prolapse, maintaining a healthy lifestyle, including a balanced diet, regular exercise, and proper bowel habits, can help reduce the risk. Seeking prompt medical attention for any persistent issues with bowel movements or pelvic floor dysfunction can also aid in early detection and treatment, potentially preventing the condition from worsening.

The Importance of Seeking Medical Attention for Rectal Prolapse

If you suspect you may have rectal prolapse, it is crucial to seek medical attention. While the condition may not be a medical emergency in its early stages, ignoring the symptoms can lead to more severe complications and a lower quality of life. Your doctor can properly diagnose the condition, determine the underlying cause, and recommend the most appropriate treatment plan to address your specific needs and improve your overall health and well-being.

Rectal Prolapse: Symptoms, Causes, Treatment, Surgery

Written by WebMD Editorial Contributors

• What Is Rectal Prolapse?
• Types of Rectal Prolapse
• Rectal Prolapse Symptoms
• Rectal Prolapse Causes
• Rectal Prolapse Risk Factors
• Rectal Prolapse Diagnosis
• Rectal Prolapse Treatment
• Rectal Prolapse Prevention
• Rectal Prolapse Complications
• More

Prolapse is when any body part slips or falls down from its normal position. Rectal prolapse is when your rectum — the last section of your large intestine — drops down or slides out of your anus. While that may sound scary, it’s typically not considered a medical emergency. However, the longer you have the condition, the worse it can get. Living with rectal prolapse can cause embarrassment and affect your quality of life.

If you feel like something just isn’t right when you go to the bathroom, or try to poop, you shouldn’t ignore it or make light of it. Your doctor can diagnose rectal prolapse and suggest treatment to fix it.

There are three types of prolapse:

• External prolapse: The entire rectum sticks out of your anus.
• Mucosal prolapse: Part of the rectal lining pokes out of your anus.
• Internal prolapse: The rectum has started to drop but is not yet sticking out of your anus.

If you feel like you’re sitting on a ball after pooping, or if you notice that you have something sticking out of the opening (your anus) where you poop, you could have rectal prolapse.

Typically, you’ll first experience rectal prolapse after you have a bowel movement. The first time, or first few times, the rectum may return inside on its own. Later, you may feel like something has fallen out of your body, or you just feel something down there that isn’t normal. In those cases, you may be able to push the rectum back in yourself.

Additional symptoms of rectal prolapse can include:

• Feeling a bulge outside your anus
• Seeing a red mass outside your anal opening
• Pain in the anus or rectum
• Bleeding from the rectum
• Leaking blood, poop, or mucus from the anus

Early on, rectal prolapse may look like hemorrhoids slipping out of your anal opening, but these are two different conditions. Hemorrhoids are swollen blood vessels in your anus or lower rectum that may cause itching, pain, and blood on the toilet paper when you wipe after you poop. Your doctor can diagnose whether you have rectal prolapse or hemorrhoids.

A variety of things can cause the condition, including:

• Long-term history of diarrhea or constipation
• Long-term history of having to strain when you poop
• Old age, which weakens muscles and ligaments in the rectal area
• Previous injury to the anal or hip area
• Nerve damage that affects your muscles’ ability to tighten and loosen, which could be caused by pregnancy, vaginal childbirth complications, anal sphincter paralysis, or injury to your spine or back
• Neurological problems, such as spinal cord disease or spinal cord transection

More women develop rectal prolapse than men, especially women older than 50. In general, older people who have had a history of constipation or problems with their pelvic floor have a higher chance of having the problem.

Any of these health conditions could put you at higher risk for rectal prolapse:

• Chronic constipation
• Always have to strain to poop
• Lower back injury or disc disease
• Muscle weakness in your anus or pelvic floor
• Someone in your family also had rectal prolapse
• Parasitic infections like schistosomiasis
• Chronic obstructive pulmonary disorder (COPD)
• Benign prostatic hypertrophy
• Any injury or problems with ligaments that keep your rectum attached to the intestinal wall
• Congenital bowel disorders like Hirschsprung’s disease or neuronal intestinal dysplasia

Your doctor can do a rectal exam. While you may hesitate to do this, your doctor may ask you to sit on a toilet and poop or at least try to go. This is helpful because it allows your doctor to see the prolapse.

You may need some other, more advanced tests to diagnose rectal prolapse, especially if you have other related conditions:

• Anal electromyography (EMG):This test checks to see if nerve damage is causing your anal sphincter problems.
• Anal manometry: A thin tube is inserted into your rectum to test muscle strength.
• Anal ultrasound: A probe inserted into your anus and rectum is used to examine muscles and tissues.
• Pudendal nerve terminal motor latency test: It checks your pudendal nerves, which you use to control bowel movements.
• Proctography:X-ray videos of your rectum during a poop show how well it holds and releases feces.
• Colonoscopy: A long tube inserted into your rectum with a tiny camera at the end can show the inside of your intestines and look for any problems that may be causing your prolapse.
• Proctosigmoidoscopy:This test also uses a long tube with a camera on the end. It’s inserted deep into your intestines to look for inflammation, scarring, or a tumor.
• MRI: Imaging scan examines all of the organs in your pelvic area.

The most common treatment for rectal prolapse is surgery to put the rectum back in place, and there are several types. The kind of surgery your doctor recommends will depend on factors such as your overall health, age, and how serious your condition is. The two most common types of surgery:

• Abdominal: This type of surgery can be done either with a large incision or using laparoscopy, which uses small cuts and a camera attached to an instrument so the surgeon can see what needs to be done and if there are any additional issues that need to be fixed.
• Perineal: Also called rectal repair, this approach may be used if you are older or have other medical problems. This type of surgery can involve the inner lining of the rectum or the portion of the rectum extending out of the anus.

If your rectal prolapse is very minor and it is caught early, your doctor might have you treat it by taking stool softeners to make it easier to go to the bathroom and by pushing the rectum’s tissue back up the anus by hand. But, typically, you will eventually need to have surgery to fix rectal prolapse.

To prevent rectal prolapse, try not to strain when you poop. Try these tips to ease or prevent constipation that leads to straining:

• Get more fiber in your diet. Aim for at least five servings of fruits and veggies each day.
• Drink 6 to 8 glasses of water a day.
• Get regular exercise.
• Keep your weight at a healthy level or lose weight if you need to.
• If you have constipation often, talk to your doctor. They may direct you to take a stool softener or laxative.

Avoid heavy lifting, as this could put pressure on your bowel muscles.

Rectal prolapse, if it’s not treated, could lead to these complications:

• Rectal damage like ulceration or bleeding
• Your rectum can’t be manually pushed back up inside you
• Strangulation, or the blood supply in your rectum is reduced
• Gangrene, or the strangulated rectal tissue decays and dies

Top Picks

Rectal Prolapse: Symptoms, Causes, Treatment, Surgery

Written by WebMD Editorial Contributors

• What Is Rectal Prolapse?
• Types of Rectal Prolapse
• Rectal Prolapse Symptoms
• Rectal Prolapse Causes
• Rectal Prolapse Risk Factors
• Rectal Prolapse Diagnosis
• Rectal Prolapse Treatment
• Rectal Prolapse Prevention
• Rectal Prolapse Complications
• More

Prolapse is when any body part slips or falls down from its normal position. Rectal prolapse is when your rectum — the last section of your large intestine — drops down or slides out of your anus. While that may sound scary, it’s typically not considered a medical emergency. However, the longer you have the condition, the worse it can get. Living with rectal prolapse can cause embarrassment and affect your quality of life.

If you feel like something just isn’t right when you go to the bathroom, or try to poop, you shouldn’t ignore it or make light of it. Your doctor can diagnose rectal prolapse and suggest treatment to fix it.

There are three types of prolapse:

• External prolapse: The entire rectum sticks out of your anus.
• Mucosal prolapse: Part of the rectal lining pokes out of your anus.
• Internal prolapse: The rectum has started to drop but is not yet sticking out of your anus.

If you feel like you’re sitting on a ball after pooping, or if you notice that you have something sticking out of the opening (your anus) where you poop, you could have rectal prolapse.

Typically, you’ll first experience rectal prolapse after you have a bowel movement. The first time, or first few times, the rectum may return inside on its own. Later, you may feel like something has fallen out of your body, or you just feel something down there that isn’t normal. In those cases, you may be able to push the rectum back in yourself.

Additional symptoms of rectal prolapse can include:

• Feeling a bulge outside your anus
• Seeing a red mass outside your anal opening
• Pain in the anus or rectum
• Bleeding from the rectum
• Leaking blood, poop, or mucus from the anus

Early on, rectal prolapse may look like hemorrhoids slipping out of your anal opening, but these are two different conditions. Hemorrhoids are swollen blood vessels in your anus or lower rectum that may cause itching, pain, and blood on the toilet paper when you wipe after you poop. Your doctor can diagnose whether you have rectal prolapse or hemorrhoids.

A variety of things can cause the condition, including:

• Long-term history of diarrhea or constipation
• Long-term history of having to strain when you poop
• Old age, which weakens muscles and ligaments in the rectal area
• Previous injury to the anal or hip area
• Nerve damage that affects your muscles’ ability to tighten and loosen, which could be caused by pregnancy, vaginal childbirth complications, anal sphincter paralysis, or injury to your spine or back
• Neurological problems, such as spinal cord disease or spinal cord transection

More women develop rectal prolapse than men, especially women older than 50. In general, older people who have had a history of constipation or problems with their pelvic floor have a higher chance of having the problem.

Any of these health conditions could put you at higher risk for rectal prolapse:

• Chronic constipation
• Always have to strain to poop
• Lower back injury or disc disease
• Muscle weakness in your anus or pelvic floor
• Someone in your family also had rectal prolapse
• Parasitic infections like schistosomiasis
• Chronic obstructive pulmonary disorder (COPD)
• Benign prostatic hypertrophy
• Any injury or problems with ligaments that keep your rectum attached to the intestinal wall
• Congenital bowel disorders like Hirschsprung’s disease or neuronal intestinal dysplasia

Your doctor can do a rectal exam. While you may hesitate to do this, your doctor may ask you to sit on a toilet and poop or at least try to go. This is helpful because it allows your doctor to see the prolapse.

You may need some other, more advanced tests to diagnose rectal prolapse, especially if you have other related conditions:

• Anal electromyography (EMG):This test checks to see if nerve damage is causing your anal sphincter problems.
• Anal manometry: A thin tube is inserted into your rectum to test muscle strength.
• Anal ultrasound: A probe inserted into your anus and rectum is used to examine muscles and tissues.
• Pudendal nerve terminal motor latency test: It checks your pudendal nerves, which you use to control bowel movements.
• Proctography:X-ray videos of your rectum during a poop show how well it holds and releases feces.
• Colonoscopy: A long tube inserted into your rectum with a tiny camera at the end can show the inside of your intestines and look for any problems that may be causing your prolapse.
• Proctosigmoidoscopy:This test also uses a long tube with a camera on the end. It’s inserted deep into your intestines to look for inflammation, scarring, or a tumor.
• MRI: Imaging scan examines all of the organs in your pelvic area.

The most common treatment for rectal prolapse is surgery to put the rectum back in place, and there are several types. The kind of surgery your doctor recommends will depend on factors such as your overall health, age, and how serious your condition is. The two most common types of surgery:

• Abdominal: This type of surgery can be done either with a large incision or using laparoscopy, which uses small cuts and a camera attached to an instrument so the surgeon can see what needs to be done and if there are any additional issues that need to be fixed.
• Perineal: Also called rectal repair, this approach may be used if you are older or have other medical problems. This type of surgery can involve the inner lining of the rectum or the portion of the rectum extending out of the anus.

If your rectal prolapse is very minor and it is caught early, your doctor might have you treat it by taking stool softeners to make it easier to go to the bathroom and by pushing the rectum’s tissue back up the anus by hand. But, typically, you will eventually need to have surgery to fix rectal prolapse.

To prevent rectal prolapse, try not to strain when you poop. Try these tips to ease or prevent constipation that leads to straining:

• Get more fiber in your diet. Aim for at least five servings of fruits and veggies each day.
• Drink 6 to 8 glasses of water a day.
• Get regular exercise.
• Keep your weight at a healthy level or lose weight if you need to.
• If you have constipation often, talk to your doctor. They may direct you to take a stool softener or laxative.

Avoid heavy lifting, as this could put pressure on your bowel muscles.

Rectal prolapse, if it’s not treated, could lead to these complications:

• Rectal damage like ulceration or bleeding
• Your rectum can’t be manually pushed back up inside you
• Strangulation, or the blood supply in your rectum is reduced
• Gangrene, or the strangulated rectal tissue decays and dies

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Bowel prolapse (rectal prolapse)

The human intestine is characterized by a large length, as a rule, the length is four meters. The final section of the intestine is represented by the rectum, in which feces are formed and their output to the outside. According to the norm, the rectum should be tightly attached and not move. However, a pathological condition can also be observed when the rectum extends beyond the anus.

This disease in medicine is characterized as rectal prolapse. When the intestine prolapses, the lower part of the rectum is stretched and falls out of the anus. As a result, patients may experience gas and fecal incontinence. The problem of bowel prolapse can be faced by people of all ages, including children. The pathological segment corresponds in length to scales from one to twenty centimeters.

Prolapse of the rectum can be internal (hidden) and external. The difference lies in the fact that with internal prolapse, the rectum has already lost its position, but it has not yet fallen out.

Rectal prolapse can occur in a hernial form, meaning that the anterior wall of the organ is displaced due to weakened pelvic muscles and high pressure in the abdominal cavity; as well as the invagination form, which is possible when a segment of the sigmoid or rectum is pressed inside the anus mucosa.

The problem of rectal prolapse has been studied for more than a hundred years, and during this time several classifications of this disease have been proposed. Among them, the most popular are the following fallout classifications:

• The first degree suggests that the rectum protrudes only during defecation.
• The second degree is characterized by prolapse of the rectum, not only during defecation, but during exercise.
• The third degree is associated with prolapse of the rectum when walking and even when the person is in an upright position.

Causes of rectal prolapse

The main cause of rectal prolapse is intestinal intussusception. However, the disease provocateurs include anatomical or genetic features of the human body, expressed in weak muscles located in the pelvic floor and unable to cope with the load during defecation, and therefore gradually stretch; abnormal location of the uterus relative to the rectum; elongated mesentery – a ligament connecting the posterior and anterior walls of the peritoneum; elongated sigmoid colon; anomalies in the structure of the sacrum and coccyx; weak anal sphincter.

These causes are associated with congenital pathologies, but may also have a traumatic nature. The muscles of the pelvic floor and anal sphincter can weaken in a woman after a natural birth. Due to surgery, injuries of the anterior abdominal wall, perineum, rectum or anus, the holding abilities of muscles and ligaments change.

How to treat rectal prolapse in adults

To eliminate rectal prolapse, conservative and surgical treatment is carried out. Patients are advised to follow a diet, perform a set of exercises to strengthen the muscles of the pelvic floor, anal sphincter and perineum in order to normalize the stool. In order for the disease not to progress, the patient completely excludes physical activity.

MEDICAL THERAPY

In the first stages of the disease, the use of conservative treatment is recommended, when the retraction of the rectum occurs independently. The goals of therapy are to reduce unpleasant symptoms; eliminate constipation and diarrhea; restore the tone of the anal sphincter and rectum.

The list of drugs is not numerous. In most cases, drugs are prescribed that can regulate stool. We are talking about laxative suppositories or oral preparations (tablets, powders for preparing drinks. If the patient experiences severe pain, it is necessary to start taking painkillers.

SURGICAL INTERVENTION

Surgical treatment is used at stages 3 and 4 of rectal prolapse, as well as if conservative therapy has been ineffective. In medicine, it is customary to talk about several methods that fix the rectum in a physiologically correct position. All methods are differentiated into several groups, the difference of which is related to the principle of influence on organs.

Consider the main methods of surgical treatment of rectal prolapse, presented by methods of narrowing the anus; operations of rectopexy or attachment of the distal rectum to the fixed parts of the small pelvis; colopexy – transperitoneal fixation of the distal sigmoid colon to the fixed formations of the pelvis or abdominal wall; operations aimed at strengthening the pelvic floor and perineum; partial or complete resection of the prolapsed intestine.

COMPLICATIONS

The most common form of complication of rectal prolapse is strangulation of the prolapsed portion of the rectum. If treatment was started late, there is a risk of developing necrosis of the strangulated tissues.

PREVENTION

Prevention suggests that, firstly, it is necessary to eliminate heavy physical exertion and other factors that develop these pathologies, and, secondly, to normalize the digestive tract.

THERE ARE CONTRAINDICATIONS. YOU NEED TO CONSULT WITH A SPECIALIST

The materials posted on this page are for informational purposes and are intended for educational purposes. Site visitors should not use them as medical advice. Determining the diagnosis and choosing a treatment method remains the exclusive prerogative of your doctor!

Causes of irritable bowel syndrome

The causes of irritable bowel syndrome (IBS) are not well established, but likely involve a combination of biological, psychological and social factors. IBS used to be called mucosal colitis, spastic colon, or intestinal neurosis. IBS is now also called functional bowel disease.

In some patients, symptoms of irritable bowel syndrome appeared immediately after a disease caused by a bacterial infection, such as acute gastroenteritis. Practitioners have recognized this “post-infectious IBS” for many years, and it is becoming increasingly clear that, in at least some patients, infection and inflammation may play a key role in the onset of IBS symptoms. In addition, post-infectious irritable bowel syndrome is more common among women and people who experience severe stress. These symptoms may last for months or years after the infection and inflammation subside.

Depression and anxiety are often associated with IBS. Some research suggests that IBS may be more common in people who have just been traumatized. Despite the psychological factors, the symptoms do exist and have a physiological basis. Although stress can exacerbate IBS symptoms, other factors such as colon mobility and nerve sensitivity in the colon also play an important role (colon motility is the contraction of the intestinal muscles and the movement of its contents, which are controlled by nerves and hormones).

The condition of IBS is indeed very annoying – there is often severe discomfort and malaise. However, the good news is that this syndrome does not permanently damage the gut, causing intestinal bleeding, cancer, or inflammatory bowel disease (such as Crohn’s disease or ulcerative colitis). However, if IBS is left untreated, its symptoms will not go away and lead to pain and discomfort.

How the large intestine works

The length of the colon or large intestine is about 1.5 m. Its main function is to absorb water and salt from digested food coming from the small intestine. Every day, about two 2 liters of fluid enters the large intestine from the small intestine, which can remain there for several days until all the liquid and salts are absorbed. The remaining mass – feces – is excreted through the large intestine to the terminal section of the intestine, where it remains until the act of defecation.

The contractions of the large intestine slowly move its contents back and forth, but mainly towards the rectum.