Mucosa prolapse. Rectal Prolapse: Causes, Symptoms, and Treatment Options

21.09.202308.07.2023 by alexxlab

What are the main causes of rectal prolapse. How is rectal prolapse diagnosed. What are the available treatment options for rectal prolapse. Who is most at risk for developing rectal prolapse. How can rectal prolapse be prevented.

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Understanding Rectal Prolapse: An Overview

Rectal prolapse is a condition where the rectum, the final portion of the large intestine, turns itself inside out and protrudes through the anus. This medical issue can cause significant discomfort and affect a person’s quality of life. While the exact cause remains unknown, several risk factors have been identified.

Interestingly, women are six times more likely to experience rectal prolapse compared to men. Additionally, children under the age of three are also commonly affected, although in most cases, the condition resolves on its own without surgical intervention.

Types of Rectal Prolapse

Rectal prolapse is classified into three main types based on its severity:

Internal prolapse: The rectum has prolapsed but hasn’t protruded through the anus.
Mucosal prolapse: Only the inner lining of the rectum protrudes through the anus.
External prolapse: The entire thickness of the rectum protrudes through the anus.

Recognizing the Symptoms of Rectal Prolapse

The symptoms of rectal prolapse can vary depending on the severity of the condition. Common signs include:

Pain and discomfort in the lower abdomen
Blood and mucus discharge from the anus
Feeling of incomplete bowel evacuation
Difficulty passing bowel movements
Protrusion of the rectum through the anus
Need for excessive toilet paper use
Leakage of liquefied feces
Reduced bowel control or fecal incontinence

Is rectal prolapse always visible? In the early stages, a portion of the rectum may slip out during bowel movements but retract on its own. As the condition progresses, manual repositioning may become necessary.

Identifying the Risk Factors for Rectal Prolapse

While the precise cause of rectal prolapse remains elusive, several risk factors have been identified:

Chronic constipation and straining during bowel movements
Weakened pelvic floor and anal sphincter muscles
Advanced age (more common in individuals 65 and older)
Genetic predisposition
Parasitic infections (rare in developed countries)
Conditions that increase abdominal pressure (e.g., benign prostatic hypertrophy, COPD)
Structural issues with rectal ligaments
Congenital bowel problems
Prior lower back trauma or disc disease

Can lifestyle changes help prevent rectal prolapse? Maintaining a healthy diet rich in fiber, staying hydrated, and regular exercise can help prevent constipation, which is a significant risk factor for rectal prolapse.

Complications Associated with Rectal Prolapse

If left untreated, rectal prolapse can lead to several complications:

Rectal damage, including ulceration and bleeding
Incarceration, where the prolapsed rectum cannot be manually repositioned
Strangulation of the rectum, leading to reduced blood supply
Gangrene of the strangulated rectal section

How urgent is treatment for rectal prolapse? While not immediately life-threatening in most cases, prompt medical attention is crucial to prevent these severe complications and improve quality of life.

Diagnosing Rectal Prolapse: What to Expect

Diagnosing rectal prolapse typically involves a physical examination. In cases where the rectum retracts on its own after bowel movements, the patient may need to strain during the examination to demonstrate the prolapse.

For suspected internal prolapse, additional diagnostic tests may be necessary:

Ultrasound
Specialized X-rays
Anorectal manometry (measurement of anorectal muscle activity)

If rectal bleeding is present, further tests may be conducted to rule out other conditions such as bowel cancer. In children with rectal prolapse, testing for cystic fibrosis is important, as approximately 11% of affected children have this condition.

How accurate is the diagnosis of rectal prolapse? When performed by an experienced healthcare professional, physical examination is highly accurate in diagnosing external rectal prolapse. However, internal prolapse may require additional imaging studies for confirmation.

Treatment Options for Rectal Prolapse

The treatment approach for rectal prolapse depends on various factors, including the patient’s age, the severity of the prolapse, and the presence of other pelvic abnormalities. Options include:

Diet and lifestyle changes: This is often sufficient for treating rectal prolapse in young children. It involves increasing fiber intake, staying hydrated, and regular exercise to prevent constipation.
Non-surgical interventions: For mucosal prolapse, securing the structures in place with surgical rubber bands may be effective.
Surgical procedures: In more severe cases or when conservative treatments fail, surgery may be necessary to secure the rectum in place.

What is the success rate of rectal prolapse treatment? The success rate varies depending on the treatment method and individual factors. Surgical interventions generally have high success rates, with many patients experiencing significant improvement in symptoms and quality of life.

Surgical Approaches for Rectal Prolapse

When surgery is necessary to treat rectal prolapse, two main approaches are available:

Abdominal approach: This involves making incisions in the abdomen to access and secure the rectum.
Perineal approach: This method involves operating through the anus, which may be preferred for patients who are not good candidates for abdominal surgery.

The choice between these approaches depends on various factors, including the patient’s overall health, age, and the severity of the prolapse.

What are the recovery times for rectal prolapse surgery? Recovery times can vary depending on the surgical approach and individual factors. Generally, patients undergoing the perineal approach may have shorter hospital stays and quicker recovery times compared to those undergoing abdominal surgery.

Preventing Rectal Prolapse: Lifestyle Modifications

While not all cases of rectal prolapse can be prevented, certain lifestyle modifications may help reduce the risk:

Maintaining a high-fiber diet to prevent constipation
Staying well-hydrated
Engaging in regular physical activity
Practicing proper toilet habits (avoiding straining and prolonged sitting)
Performing pelvic floor exercises to strengthen the muscles

Can pelvic floor exercises help with rectal prolapse? Yes, strengthening the pelvic floor muscles through targeted exercises can help support the rectum and potentially reduce the risk of prolapse or its recurrence after treatment.

Special Considerations for Different Age Groups

The approach to rectal prolapse can vary depending on the age of the affected individual:

Children: In young children, dietary changes and addressing underlying constipation issues are often sufficient to resolve rectal prolapse without surgery.
Adults: A combination of conservative measures and surgical interventions may be necessary, depending on the severity of the prolapse and associated symptoms.
Elderly patients: The choice of treatment may be influenced by overall health status and the ability to tolerate surgical procedures.

How does the treatment approach differ for children versus adults with rectal prolapse? In children, conservative measures are often prioritized and can be highly effective. Adults may require more aggressive treatment, including surgery, especially if conservative measures fail to provide relief.

Living with Rectal Prolapse: Coping Strategies and Support

Dealing with rectal prolapse can be challenging, both physically and emotionally. Here are some strategies to help cope with the condition:

Educate yourself about the condition and available treatment options
Maintain open communication with your healthcare provider
Join support groups or online communities for individuals with similar experiences
Practice good hygiene to prevent complications
Manage stress through relaxation techniques or counseling if needed
Adhere to recommended dietary and lifestyle modifications

Are there any long-term effects of rectal prolapse? With proper treatment and management, many individuals with rectal prolapse can experience significant improvement in their symptoms and quality of life. However, some may experience ongoing issues with bowel function, necessitating continued care and follow-up.

The Importance of Regular Check-ups

Regular follow-up appointments with a healthcare provider are crucial for individuals who have experienced rectal prolapse. These check-ups allow for:

Monitoring of the condition’s progression or improvement
Adjustment of treatment plans as needed
Early detection of any complications or recurrence
Addressing any concerns or questions the patient may have

How often should follow-up appointments be scheduled after treatment for rectal prolapse? The frequency of follow-up appointments can vary depending on the individual case and treatment received. Initially, more frequent check-ups may be necessary, with the interval between appointments potentially increasing as the condition stabilizes.

Advances in Rectal Prolapse Research and Treatment

The field of rectal prolapse management is continuously evolving, with ongoing research aimed at improving diagnostic techniques and treatment outcomes. Some areas of focus include:

Minimally invasive surgical techniques
Advanced imaging methods for better diagnosis of internal prolapse
Novel approaches to strengthening pelvic floor muscles
Improved understanding of the underlying causes of rectal prolapse

What new treatments for rectal prolapse are on the horizon? While specific new treatments are still in various stages of research and development, the trend is towards less invasive procedures and more personalized treatment approaches based on individual patient factors.

The Role of Multidisciplinary Care

Managing rectal prolapse often requires a multidisciplinary approach, involving various healthcare professionals such as:

Colorectal surgeons
Gastroenterologists
Pelvic floor physical therapists
Nutritionists
Mental health professionals (if needed for emotional support)

How does a multidisciplinary approach benefit patients with rectal prolapse? This comprehensive care model ensures that all aspects of the condition are addressed, from surgical intervention to lifestyle modifications and emotional well-being, potentially leading to better overall outcomes and quality of life for patients.

Rectal Prolapse in Special Populations

While rectal prolapse can affect anyone, certain populations may require special considerations:

Rectal Prolapse in Pregnancy and Postpartum

Pregnancy and childbirth can increase the risk of rectal prolapse due to the strain on pelvic floor muscles. Management in these cases often focuses on conservative measures and pelvic floor rehabilitation. Surgical intervention, if necessary, is typically delayed until after childbirth and recovery.

Rectal Prolapse in the Elderly

Older adults may be at higher risk for rectal prolapse due to weakened muscles and tissues. Treatment decisions must carefully weigh the benefits of intervention against potential risks, considering the individual’s overall health status and life expectancy.

Rectal Prolapse in Individuals with Neurological Disorders

People with certain neurological conditions, such as multiple sclerosis or spinal cord injuries, may be at increased risk for rectal prolapse. Management in these cases often requires a tailored approach, considering the underlying neurological condition and its impact on bowel function.

How does the management of rectal prolapse differ in these special populations? The approach often needs to be more conservative, with a greater emphasis on non-surgical interventions and careful consideration of individual risk factors and overall health status.

The Psychological Impact of Rectal Prolapse

The physical symptoms of rectal prolapse can have significant psychological effects on individuals, including:

Embarrassment and social anxiety
Depression
Reduced self-esteem
Relationship difficulties
Fear of public situations

Addressing these psychological aspects is crucial for comprehensive care. Mental health support, either through counseling or support groups, can be beneficial in helping individuals cope with the emotional challenges of living with rectal prolapse.

How can healthcare providers better address the psychological impact of rectal prolapse? Integrating mental health screening and support into the treatment plan, providing patient education, and fostering open communication can help address the psychological aspects of rectal prolapse more effectively.

The Role of Patient Education

Educating patients about rectal prolapse is crucial for effective management and treatment adherence. Key areas of focus include:

Understanding the condition and its causes
Recognizing symptoms and potential complications
Learning about treatment options and their potential outcomes
Understanding the importance of lifestyle modifications
Knowing when to seek medical attention

How can patient education be improved for individuals with rectal prolapse? Utilizing various educational formats such as written materials, videos, and interactive sessions can help cater to different learning styles and improve overall understanding of the condition.

Rectal prolapse – Better Health Channel

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Summary

Read the full fact sheet

We do not know the exact cause of rectal prolapse, but risk factors include chronic constipation, straining to pass bowel motions, and weakened pelvic floor muscles.
Treatment includes surgery, performed through the abdomen or via the anus, to tether the rectum into place.
A diet that successfully treats constipation is often all that’s needed to cure rectal prolapse in young children.

The rectum is the last 20 cm or so of the large bowel. It is the temporary storage area for bowel motions. Rectal prolapse occurs when the rectum turns itself inside out and comes out through the anus. Without treatment, the rectum will eventually need to be pushed back in manually.

Women are six times more likely to suffer rectal prolapse than men. Children of both sexes under the age of three years are also commonly affected by rectal prolapse, although the prolapse tends to resolve by itself without the need for surgery.

In the early stages of rectal prolapse, a portion of the rectum slips out while passing a bowel motion, but it goes back inside by itself.

Symptoms of rectal prolapse

The symptoms of rectal prolapse depend on the severity, but can include:

Pain and discomfort felt deep within the lower abdomen
Blood and mucus from the anus
The feeling of constipation, or that the rectum is never completely emptied after passing a motion
Difficulties passing a bowel motion
Protrusion of the rectum through the anus
The need to use huge quantities of toilet paper to clean up following a bowel motion
Leakage of liquefied faeces, particularly following a bowel motion
Faecal incontinence, or reduced ability to control the bowels.

Types of rectal prolapse

Rectal prolapse is graded according to its severity, including:

Internal prolapse – the rectum has prolapsed, but not so far as to slip through the anus. This is also known as incomplete prolapse
Mucosal prolapse – the interior lining of the rectum protrudes through the anus
External prolapse – the entire thickness of the rectum protrudes through the anus. This is also known as complete or full-thickness prolapse.

Causes of rectal prolapse

The exact cause of rectal prolapse is unknown, but risk factors include:

Chronic constipation
Straining to pass bowel motions
Weakened pelvic floor muscles
Weakened anal sphincter muscles
Weakening of the muscles associated with ageing, since rectal prolapse is more common in people aged 65 years and over
Genetic susceptibility, since it appears that some people with rectal prolapse have a blood relative with the same condition
Parasitic infection, such as schistosomiasis – very rare in Australia
Any condition that chronically increases pressure within the abdomen, such as benign prostatic hypertrophy, or chronic obstructive pulmonary disease (COPD)
Structural problems with the ligaments that tether the rectum to its surrounds
Congenital problems of the bowel, such as Hirschsprung’s disease or neuronal intestinal dysplasia
Prior trauma to the lower back
Disc disease in the lower back.

Complications of rectal prolapse

Complications of rectal prolapse include:

Risk of damage to the rectum, such as ulceration and bleeding
Incarceration – the rectum can’t be manually pushed back inside the body
Strangulation of the rectum – the blood supply is reduced
Death and decay (gangrene) of the strangulated section of the rectum.

Diagnosis of rectal prolapse

Rectal prolapse is diagnosed by examination. In cases where the rectum goes back inside by itself after passing a bowel motion, the person may have to bear down during examination by the doctor to show the prolapse in order to confirm the diagnosis.

In cases of suspected internal prolapse, diagnostic tests may include ultrasound, special x-rays and measurement of the anorectal muscle activity (anorectal manometry). If the person has experienced rectal bleeding, the doctor may want to do a number of tests to check for other conditions such as bowel cancer.

About 11 per cent of children with rectal prolapse have cystic fibrosis, so it is important to test young people for this condition too.

Treatment for rectal prolapse

Treatment depends on many individual factors, such as the age of the person, the severity of the prolapse, and whether or not other pelvic abnormalities are present (such as prolapsed bladder). Treatment options can include:

Diet and lifestyle changes to treat chronic constipation – for example, more fruit, vegetables and wholegrain foods, increased fluid intake and regular exercise. This option is often all that’s needed to successfully treat rectal prolapse in young children
Securing the structures in place with surgical rubber bands – in cases of mucosal prolapse
Surgery.

Surgery for rectal prolapse

Surgery is sometimes used to secure the rectum into place. It can be performed through the person’s abdomen or via their anus. One operation involves tethering the rectum to the central bone of the pelvis (sacrum). Another operation is to remove the prolapsed part of the rectum and to rejoin the bowel to restore near-normal bowel function.

Although surgery through the abdomen may give better long-term results, older people may be advised to undergo surgical correction via the anus, since it is easier to recover from this procedure.

Before surgery for rectal prolapse

The day before surgery, you will be asked to fast, and may need to drink a special preparation to help flush out your bowels. Once you are in hospital, the anaesthetist will visit you to see what sort of anaesthetic is best for you. You may be given medication in the hours before the operation to prepare you for anaesthesia and make you feel drowsy.

Rectal prolapse operation procedure

The various types of surgery include:

Laparotomy (open abdominal surgery) – the surgeon uses a single, large incision (cut) in the abdomen. Then the surgeon carefully moves aside the overlying organs. To stop the rectum prolapsing, it is lifted, pulled straight and stitched directly to the inner surface of the sacrum (central bone of the pelvis). Sometimes, a short length of bowel may be removed
Laparoscopy (keyhole abdominal surgery) – laparoscopy may be possible in some cases. This involves inserting slender instruments through a number of small incisions in the abdomen. Recovery time following laparoscopy is usually quicker than open surgery
Anal surgery – under anaesthesia, the surgeon gently pulls out the prolapsed bowel through the anus. The prolapsed section of bowel is usually removed and the structural damage repaired. The bowel is rejoined and returned back through the anus to restore normal bowel function and appearance.

Other forms of treatment for rectal prolapse

Surgery is the best option for severe rectal prolapse. Other possible forms of treatment may include:

Lifestyle changes – including high-fibre diet, drinking plenty of water and getting regular exercise
Change to toileting habits – such as not straining when trying to pass a bowel motion. This may require using fibre supplements or laxatives.

Immediately after surgery for rectal prolapse

After your operation for rectal prolapse or rectocele, things you can expect include:

Hospital staff will observe and note your temperature, pulse, breathing and blood pressure.
You will have an intravenous fluid line in your arm to replace fluids in your body.
You will receive pain-relieving medications. Tell your nurse if you need more pain relief.
You may have a catheter to drain off urine for the next day or so, or until you can empty your bladder by yourself.
If you have a vaginal pack, this will be taken out later the same day or the day after surgery.
You may be in hospital for three to six days following surgery.
You will need to make follow-up appointments with your doctor.

Complications of surgery for rectal prolapse

Possible complications of surgery include:

Allergic reaction to the anaesthetic
Haemorrhage
Infection
Injury to nearby nerves or blood vessels
Damage to other pelvic organs, such as the bladder or rectum
Death (necrosis) of the rectal wall
Recurrence of the rectal prolapse.

Taking care of yourself at home after surgery for rectal prolapse

Be guided by your doctor, but general suggestions include:

Rest as much as you can.
Avoid heavy lifting or straining for a few weeks.
Don’t strain on the toilet.
Take measures to prevent constipation, such as eating high-fibre foods and drinking plenty of water.
After rectocele surgery, expect bloody vaginal discharge for about four weeks.
Contact your doctor if you experience any unusual symptoms, such as difficulties with urination, heavy bleeding, fever, or signs of infection around the wound sites.
You can expect to return to work around six weeks after surgery.
Attend follow-up appointments with your surgeon.

Long-term outlook after surgery for rectal prolapse

While surgery through the abdomen gives better results, older people may be advised to undergo surgical correction of rectal prolapse via the anus, since this procedure is less stressful on the body.

Surgery gives good results in most cases of rectal prolapse, but some people may find that symptoms such as constipation or the inability to completely empty the bowels continue.

Unfortunately for women with rectocele, the problem will recur after surgery in about 10 per cent of cases.

Where to get help

Your doctor
Colorectal or general surgeon

Things to remember

We do not know the exact cause of rectal prolapse, but risk factors include chronic constipation, straining to pass bowel motions, and weakened pelvic floor muscles.
Treatment includes surgery, performed through the abdomen or via the anus, to tether the rectum into place.
A diet that successfully treats constipation is often all that’s needed to cure rectal prolapse in young children.

This page has been produced in consultation with and approved
by:

Give feedback about this page

Was this page helpful?

More information

Content disclaimer

Content on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances. The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website.

Reviewed on: 30-09-2014

Rectal prolapse – Better Health Channel

Actions for this page

Summary

Read the full fact sheet

We do not know the exact cause of rectal prolapse, but risk factors include chronic constipation, straining to pass bowel motions, and weakened pelvic floor muscles.
Treatment includes surgery, performed through the abdomen or via the anus, to tether the rectum into place.
A diet that successfully treats constipation is often all that’s needed to cure rectal prolapse in young children.

In the early stages of rectal prolapse, a portion of the rectum slips out while passing a bowel motion, but it goes back inside by itself.

Symptoms of rectal prolapse

The symptoms of rectal prolapse depend on the severity, but can include:

Pain and discomfort felt deep within the lower abdomen
Blood and mucus from the anus
The feeling of constipation, or that the rectum is never completely emptied after passing a motion
Difficulties passing a bowel motion
Protrusion of the rectum through the anus
The need to use huge quantities of toilet paper to clean up following a bowel motion
Leakage of liquefied faeces, particularly following a bowel motion
Faecal incontinence, or reduced ability to control the bowels.

Types of rectal prolapse

Rectal prolapse is graded according to its severity, including:

Internal prolapse – the rectum has prolapsed, but not so far as to slip through the anus. This is also known as incomplete prolapse
Mucosal prolapse – the interior lining of the rectum protrudes through the anus
External prolapse – the entire thickness of the rectum protrudes through the anus. This is also known as complete or full-thickness prolapse.

Causes of rectal prolapse

The exact cause of rectal prolapse is unknown, but risk factors include:

Chronic constipation
Straining to pass bowel motions
Weakened pelvic floor muscles
Weakened anal sphincter muscles
Weakening of the muscles associated with ageing, since rectal prolapse is more common in people aged 65 years and over
Genetic susceptibility, since it appears that some people with rectal prolapse have a blood relative with the same condition
Parasitic infection, such as schistosomiasis – very rare in Australia
Any condition that chronically increases pressure within the abdomen, such as benign prostatic hypertrophy, or chronic obstructive pulmonary disease (COPD)
Structural problems with the ligaments that tether the rectum to its surrounds
Congenital problems of the bowel, such as Hirschsprung’s disease or neuronal intestinal dysplasia
Prior trauma to the lower back
Disc disease in the lower back.

Complications of rectal prolapse

Complications of rectal prolapse include:

Risk of damage to the rectum, such as ulceration and bleeding
Incarceration – the rectum can’t be manually pushed back inside the body
Strangulation of the rectum – the blood supply is reduced
Death and decay (gangrene) of the strangulated section of the rectum.

Diagnosis of rectal prolapse

About 11 per cent of children with rectal prolapse have cystic fibrosis, so it is important to test young people for this condition too.

Treatment for rectal prolapse

Diet and lifestyle changes to treat chronic constipation – for example, more fruit, vegetables and wholegrain foods, increased fluid intake and regular exercise. This option is often all that’s needed to successfully treat rectal prolapse in young children
Securing the structures in place with surgical rubber bands – in cases of mucosal prolapse
Surgery.

Surgery for rectal prolapse

Although surgery through the abdomen may give better long-term results, older people may be advised to undergo surgical correction via the anus, since it is easier to recover from this procedure.

Before surgery for rectal prolapse

Rectal prolapse operation procedure

The various types of surgery include:

Laparotomy (open abdominal surgery) – the surgeon uses a single, large incision (cut) in the abdomen. Then the surgeon carefully moves aside the overlying organs. To stop the rectum prolapsing, it is lifted, pulled straight and stitched directly to the inner surface of the sacrum (central bone of the pelvis). Sometimes, a short length of bowel may be removed
Laparoscopy (keyhole abdominal surgery) – laparoscopy may be possible in some cases. This involves inserting slender instruments through a number of small incisions in the abdomen. Recovery time following laparoscopy is usually quicker than open surgery
Anal surgery – under anaesthesia, the surgeon gently pulls out the prolapsed bowel through the anus. The prolapsed section of bowel is usually removed and the structural damage repaired. The bowel is rejoined and returned back through the anus to restore normal bowel function and appearance.

Other forms of treatment for rectal prolapse

Surgery is the best option for severe rectal prolapse. Other possible forms of treatment may include:

Lifestyle changes – including high-fibre diet, drinking plenty of water and getting regular exercise
Change to toileting habits – such as not straining when trying to pass a bowel motion. This may require using fibre supplements or laxatives.

Immediately after surgery for rectal prolapse

After your operation for rectal prolapse or rectocele, things you can expect include:

Hospital staff will observe and note your temperature, pulse, breathing and blood pressure.
You will have an intravenous fluid line in your arm to replace fluids in your body.
You will receive pain-relieving medications. Tell your nurse if you need more pain relief.
You may have a catheter to drain off urine for the next day or so, or until you can empty your bladder by yourself.
If you have a vaginal pack, this will be taken out later the same day or the day after surgery.
You may be in hospital for three to six days following surgery.
You will need to make follow-up appointments with your doctor.

Complications of surgery for rectal prolapse

Possible complications of surgery include:

Allergic reaction to the anaesthetic
Haemorrhage
Infection
Injury to nearby nerves or blood vessels
Damage to other pelvic organs, such as the bladder or rectum
Death (necrosis) of the rectal wall
Recurrence of the rectal prolapse.

Taking care of yourself at home after surgery for rectal prolapse

Be guided by your doctor, but general suggestions include:

Rest as much as you can.
Avoid heavy lifting or straining for a few weeks.
Don’t strain on the toilet.
Take measures to prevent constipation, such as eating high-fibre foods and drinking plenty of water.
After rectocele surgery, expect bloody vaginal discharge for about four weeks.
Contact your doctor if you experience any unusual symptoms, such as difficulties with urination, heavy bleeding, fever, or signs of infection around the wound sites.
You can expect to return to work around six weeks after surgery.
Attend follow-up appointments with your surgeon.

Long-term outlook after surgery for rectal prolapse

While surgery through the abdomen gives better results, older people may be advised to undergo surgical correction of rectal prolapse via the anus, since this procedure is less stressful on the body.

Surgery gives good results in most cases of rectal prolapse, but some people may find that symptoms such as constipation or the inability to completely empty the bowels continue.

Unfortunately for women with rectocele, the problem will recur after surgery in about 10 per cent of cases.

Where to get help

Your doctor
Colorectal or general surgeon

Things to remember

We do not know the exact cause of rectal prolapse, but risk factors include chronic constipation, straining to pass bowel motions, and weakened pelvic floor muscles.
Treatment includes surgery, performed through the abdomen or via the anus, to tether the rectum into place.
A diet that successfully treats constipation is often all that’s needed to cure rectal prolapse in young children.

This page has been produced in consultation with and approved
by:

Give feedback about this page

Was this page helpful?

More information

Content disclaimer

Reviewed on: 30-09-2014

Rectal prolapse – methods of treatment, stages of prolapse, symptoms and complications

Prices Doctors Our centers

Classification Symptoms Complications Diagnosis Treatment methods Prognosis Prevention

Rectal prolapse or rectal prolapse is a pathological condition
which is accompanied by the release of the mucosa beyond the boundaries of the anal sphincter. All layers of the diastal layer fall out
segment of the large intestine. The protruding segment in this case ranges from 2 to 20 centimeters and even more.

Often this disease is diagnosed in men, they account for 70% of clinical cases. In 30% pathology
occurs in women. Prolapse is predominantly formed in people of working age from 20 to 50 years, however
often occurs in babies 3-4 years old due to the specifics of the anatomical and physiological characteristics of the child
organism.

Causes of weakening of muscles and ligaments, which leads to prolapse of rectal nodes:

hereditary predisposition;
incorrect anatomical structure of the pelvic bones, shape and rectum and sigmoid colon, intestinal wall;
prolonged defecation disorders: diarrhoea, constipation;
excessive straining during urination;
parasitic intestinal infections;
injuries of pelvic nerves and muscles;
regular excessive physical activity, hard work, heavy lifting;
heavy or multiple childbirth in women;
diseases of the nervous system.

Classification

The official classification of human rectal prolapse is used by specialists when developing a therapeutic
scheme. It provides for the distribution of pathology into three stages:

Stage 1 (compensated) – the intestine falls out only during defecation and returns on its own
in a natural position;
stage 2 (subcompensated) – prolapse occurs during bowel movements and at high
physical exertion, accompanied by insufficiency of the anal sphincter;
stage 3 (decompensated) – prolapse of the rectum is observed even when walking, coughing, sneezing,
accompanied by incontinence of feces, gases, severe insufficiency of the sphincter.

Specialists also distinguish two types of rectal prolapse:

Hernia – Douglas pouch and anterior wall of the rectum move down, with weak muscles
pelvic floor and constant high intra-abdominal pressure lead to prolapse of the intestine into the anal canal. Through
time, all the walls are involved in the pathological process, and the sagging increases.
Invaginated or internal prolapse – part of the rectum or sigmoid colon is embedded in the lumen
other part of the intestine. In this case, the organ does not go outside, and the main symptom of pathology is regular
strong pain attacks.

Symptoms

Symptoms of pathology occur both gradually and suddenly. An unexpected start is associated with sharp and intense
loads, stress. After such an episode, the rectum falls out, and the person feels sharp pains in the abdomen, up to
to pain shock.

More often, however, rectal prolapse develops gradually. As the pathology progresses, it becomes more
pronounced and signs of loss:

sensation of a foreign body in the anus;
abdominal pain that worsens with walking, exercise, defecation;
incontinence, inability to hold back gases, stools;
frequent false urge to defecate;
sensation of incomplete bowel movements;
frequent urination;
secretion of mucus, blood from the anus;
the formation of a solitary ulcer, mucosal edema (with internal prolapse).

Complications in the absence of treatment

The most dangerous complication that occurs when ignoring prolapse is the infringement of the prolapsed segment of the intestine.
Infringement appears with untimely intervention or when you try to set the prolapse on your own.
Accompanied by edema, increasing ischemia, impaired blood supply. If you do not seek help in time,
the outer portion of the tissues will be affected by necrosis (tissue necrosis).

Another complication that pathology leads to is solitary ulcers. Such wounds cause over time
bleeding leading to perforation.

In advanced stages of internal prolapse, acute intestinal obstruction and peritonitis often occur. These are dangerous
conditions that pose a threat to human life.

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Diagnostics

A proctologist can diagnose rectal prolapse and the degree of bowel prolapse even without examination and analysis
symptoms. The prolapsed part of the organ has a cone-shaped, cylindrical or spherical shape, painted in
bright red or bluish tint. The mucous membrane is markedly swollen and bleeds on contact. On
in the early stages, you can set the intestine and restore the normal state of the tissues. If at the time of examination the prolapse is not
observed, the patient is offered to strain to provoke a prolapse.

During a digital examination, the doctor determines the tone of the sphincter, differentiates the disease from hemorrhoids and anal
polyps. After that, for an accurate diagnosis, identification of complications and the exact stage of the disease,
instrumental diagnostics, which includes:

colonoscopy – to identify the causes of the pathology;
barium enema – to detect functional changes in the colon;
defectography (proctography) – to determine the degree of prolapse;
anorectal manometry – to assess muscle function;
endoscopic examination (sigmoidoscopy) – to detect intussusception, the presence of ulcers;
endoscopic biopsy with tissue examination – is prescribed if a solitary ulcer is detected to exclude
oncology of the rectum;
gynecological examination – for women.

Methods of treatment of rectal prolapse

Conservative approaches are used only in the earliest stages of the disease. The main purpose of such events is
normalize stool and eliminate increased intra-abdominal pressure. Clinical recommendations include:

high fiber diet;
drinking plenty of water;
laxatives;
drugs to increase peristalsis;
neurostimulation, which helps to regain control of the muscles in case of impaired innervation.

Surgical methods of treatment bring results in the later stages of the development of prolapse, as well as in cases where
when conservative therapy fails. There are many operations that help get rid of
pathology. They include:

excision of the prolapsed section of the rectum;
bowel fixation;
plastic surgery of the anal canal, pelvic floor;
colon resection;
combined methods.

Resection of the prolapsed section is more often done predominantly by surgery
Delorme. The surgeon removes the mucous membrane and forms a new muscle layer in the anal canal area. Operation
has a low invasiveness and is suitable even for older patients with serious chronic pathologies.
Less commonly, resection of the prolapsed lobe is done by patchwork cutting according to Nelaton or circular removal according to Mikulich.

Among fixation methods, rectopexy is considered the most effective –
an operation in which the pelvic section of the intestine is attached to the walls of the pelvis, thus restoring the correct
organ anatomy. The operation is performed on patients under 50-55 years of age. In 97% of cases, organ prolapse is eliminated.

Anal plastic surgery helps narrow the anus with surgical sutures and wires,
synthetic materials. However, this group of methods has a high risk of recurrence, so it is rarely used.

Resection of the distal colon is necessary if the patient has a solitary ulcer or necrosis. Often
such an operation is combined with fixing operations.

SM-Clinic surgeons have experience in performing various types of prolapse surgery. Our clinicians in
are fluent in modern surgical techniques and successfully help patients get rid of pathological
bowel prolapse.

Forecast

Surgical treatment brings a positive result without recurrence in 80% of cases. In 70-75% of patients, as a result
treatment restores the evacuation capacity of the intestine. At the same time, 25-30% of patients develop disorders
transitory function.

Moreover, the earlier the patient seeks help, the more favorable the prognosis will be. Unfortunately, patients often go to
doctor only in the later stages of the development of pathology, when prolapse is already obvious, bowel functions are impaired, and in
tissues began to undergo irreversible changes. In this case, the risk of developing life-threatening complications increases in
times.

Prophylaxis

To prevent the disease, as well as to prevent relapse, doctors recommend eliminating factors that increase
intra-abdominal pressure and cause weakness of the pelvic floor muscles:

avoid injuries in the pelvis, sacrum;
physical activity, stress;
treat constipation, flatulence, diarrhea;
do not start urolithiasis, prostate adenoma;
to prevent hacking agonizing cough.

Pathology develops as a result of a combination of several factors, so for prevention it is necessary to minimize all
risks.

Specialists in this field 21 doctors

Leading doctors 6 doctors

Petrushina Marina Borisovna

Surgeon, proctologist

Work experience: 42 years

Udarnikov, 19

m. Ladozhskaya

Make an appointment

Aramyan David Surenovich

Surgeon, coloproctologist, oncologist, mammologist

Work experience: 13 years Reception

Yaroslav Viktorovich Kolosovsky

Surgeon, mammologist, oncologist

Work experience: 17 years

Dybenko, 13k4

m. Dybenko Street

Karapetyan Zaven Surenovich

coloproctologist, surgeon and phlebologist

Work experience: 15 years

Dunaisky, 47

Dunayskaya metro station

Marshala Zakharov, 20

Leninskiy avenue metro station

Make an appointment 90 003 Andrey Shishkin

Surgeon, phlebologist, proctologist. Candidate of Medical Sciences

Work experience: 13 years

Dunaysky, 47

Dunayskaya metro station

Make an appointment

Maslennikov Dmitry Yurievich

Surgeon, proctologist, mammologist

Work experience: 16 years

Udarnikov, 19

Ladozhskaya metro station

Dybenko, 13k4

Dybenko street metro

Make an appointment

Show more
+15 doctors

Other doctors 15 doctors

Ardashov, Pavel Sergeevich

Coloproctologist-surgeon

Work experience: 9 years

Udarnikov, 19

persons Dybenko

Make an appointment

Bulkina Maria Sergeevna

Coloproctologist, surgeon

Work experience: 11 years

Dunaysky, 47

Dunayskaya metro station

Vyborgskoe shosse, 17

Prosveshcheniya metro station 9000 3

Make an appointment

Grinevich Vladimir Stanislavovich

Surgeon, oncologist, mammologist, coloproctologist

Work experience: 27 years

Vyborgskoe shosse, 17

m.
Klyuev Andrey

Operating proctologist

Work experience: 16 years

Malaya Balkanskaya, 23

Kupchino metro station

Make an appointment

Nekrasov Roman Aleksandrovich

Coloproctologist and surgeon

Work experience: 8 years

Udarnikov, 19

Ladozhskaya metro station

Marshala Zakharov, 20

Leninsky pr. -t

Make an appointment

Petrova Vitalina Vasilievna

Operating proctologist

Work experience: 12 years

Vyborgskoe shosse, 17

Prospekt Prosveshcheniya metro station

Make an appointment

Senko Vladimir Vladimirovich

Head of the Center for Surgery and Oncology

Work experience: 23 years Leninsky Prospekt

Vyborgskoe shosse, 17

m Prospect Prosveshcheniya

Make an appointment

Sinyagina (Nazarova) Maria Andreevna

Surgeon, proctologist

Work experience: 8 years

Marshala Zakharova, 20

06
Sokolova Anna Sergeevna

Coloproctologist, surgeon. Candidate of Medical Sciences.

Work experience: 13 years

Malaya Balkanskaya, 23

Kupchino metro station

Make an appointment

Sol Anton Aleksandrovich

Work experience: 15 years

Vyborgskoye shosse, 17

metro Prosveshcheniya

Make an appointment

Fomenko Nikolai Aleksandrovich

Surgeon, proctologist, oncologist

Work experience: 15 years

Marshal Zakharova, 20

m. Leninsky pr-t

Khangireev Alexander Bakhytovich

Surgeon, oncologist, coloproctologist

Work experience: 13 years

Udarnikov, 19

Ladozhskaya metro station

Dunaiskiy, 47

Dunaiskaya metro station

Make an appointment

Khokhlov Sergey Viktorovich

Surgeon, oncologist, coloproctologist

Work experience: 28 years old

Vyborg highway, 17

m. Prospekt Prospect

Chuprina Susanna Vladimirovna

Coloproctologist of the highest category

Work experience: 22 years

Udarnikov, 19

Ladozhskaya metro station

Make an appointment

Yalda Ksenia Davidovna

Coloproctologist

Work experience: 11 years

Malaya Balkanskaya, 23

Kupchino metro station

Make an appointment

Hide the list 90 003

Our offices in St.

Petersburg

6 branches

Center for Surgery Dunayskaya metro station

47 Dunaisky prospect

Dunaiskaya metro station

daily from 09:00 to 22:00

Surgery Center Ladozhskaya metro station

Udarnikov Avenue, 19/1

Ladozhskaya metro station

daily from 09:00 to 22:00

Center for Surgery Metro station “Leninsky Prospekt”

st. Marshal Zakharov, d.
daily from 09:00 to 22:00

Center for Surgery Prospekt Prosveshcheniya metro station

Vyborgskoe shosse, 17 building 1

Prospect Prosveshcheniya metro station

daily from 09:00 to 22:00

Surgery Center Kupchino metro station

Malaya Balkanskaya street, 23

Kupchino metro station

daily from 09:00 to 22:00

Center for Surgery Dybenko Street

Dybenko Street, 13k4

m. Dybenko street

daily from 09:00 to 22:00

Rectal prolapse – methods of treatment, stages of prolapse, symptoms and complications

Prices Doctors Our centers

Classification Symptoms Complications Diagnosis Treatment methods Prognosis Prevention

Causes of weakening of muscles and ligaments, which leads to prolapse of rectal nodes:

hereditary predisposition;
incorrect anatomical structure of the pelvic bones, shape and rectum and sigmoid colon, intestinal wall;
prolonged defecation disorders: diarrhoea, constipation;
excessive straining during urination;
parasitic intestinal infections;
injuries of pelvic nerves and muscles;
regular excessive physical activity, hard work, heavy lifting;
heavy or multiple childbirth in women;
diseases of the nervous system.

Classification

The official classification of human rectal prolapse is used by specialists when developing a therapeutic
scheme. It provides for the distribution of pathology into three stages:

Stage 1 (compensated) – the intestine falls out only during defecation and returns on its own
in a natural position;
stage 2 (subcompensated) – prolapse occurs during bowel movements and at high
physical exertion, accompanied by insufficiency of the anal sphincter;
stage 3 (decompensated) – prolapse of the rectum is observed even when walking, coughing, sneezing,
accompanied by incontinence of feces, gases, severe insufficiency of the sphincter.

Specialists also distinguish two types of rectal prolapse:

Hernia – Douglas pouch and anterior wall of the rectum move down, with weak muscles
pelvic floor and constant high intra-abdominal pressure lead to prolapse of the intestine into the anal canal. Through
time, all the walls are involved in the pathological process, and the sagging increases.
Invaginated or internal prolapse – part of the rectum or sigmoid colon is embedded in the lumen
other part of the intestine. In this case, the organ does not go outside, and the main symptom of pathology is regular
strong pain attacks.

Symptoms

More often, however, rectal prolapse develops gradually. As the pathology progresses, it becomes more
pronounced and signs of loss:

sensation of a foreign body in the anus;
abdominal pain that worsens with walking, exercise, defecation;
incontinence, inability to hold back gases, stools;
frequent false urge to defecate;
sensation of incomplete bowel movements;
frequent urination;
secretion of mucus, blood from the anus;
the formation of a solitary ulcer, mucosal edema (with internal prolapse).

Complications in the absence of treatment

Another complication that pathology leads to is solitary ulcers. Such wounds cause over time
bleeding leading to perforation.

In advanced stages of internal prolapse, acute intestinal obstruction and peritonitis often occur. These are dangerous
conditions that pose a threat to human life.

Promotion! Free consultation with a surgeon about surgery

Take advantage of this unique opportunity and get a free consultation about elective surgery.

Diagnostics

colonoscopy – to identify the causes of the pathology;
barium enema – to detect functional changes in the colon;
defectography (proctography) – to determine the degree of prolapse;
anorectal manometry – to assess muscle function;
endoscopic examination (sigmoidoscopy) – to detect intussusception, the presence of ulcers;
endoscopic biopsy with tissue examination – is prescribed if a solitary ulcer is detected to exclude
oncology of the rectum;
gynecological examination – for women.

Methods of treatment of rectal prolapse

high fiber diet;
drinking plenty of water;
laxatives;
drugs to increase peristalsis;
neurostimulation, which helps to regain control of the muscles in case of impaired innervation.

excision of the prolapsed section of the rectum;
bowel fixation;
plastic surgery of the anal canal, pelvic floor;
colon resection;
combined methods.

Anal plastic surgery helps narrow the anus with surgical sutures and wires,
synthetic materials. However, this group of methods has a high risk of recurrence, so it is rarely used.

Resection of the distal colon is necessary if the patient has a solitary ulcer or necrosis. Often
such an operation is combined with fixing operations.

Forecast

Prophylaxis

To prevent the disease, as well as to prevent relapse, doctors recommend eliminating factors that increase
intra-abdominal pressure and cause weakness of the pelvic floor muscles:

avoid injuries in the pelvis, sacrum;
physical activity, stress;
treat constipation, flatulence, diarrhea;
do not start urolithiasis, prostate adenoma;
to prevent hacking agonizing cough.

Pathology develops as a result of a combination of several factors, so for prevention it is necessary to minimize all
risks.

Specialists in this field 21 doctors

Leading doctors 6 doctors

Petrushina Marina Borisovna

Surgeon, proctologist

Work experience: 42 years

Udarnikov, 19

m. Ladozhskaya

Make an appointment

Aramyan David Surenovich

Surgeon, coloproctologist, oncologist, mammologist

Work experience: 13 years Reception

Yaroslav Viktorovich Kolosovsky

Surgeon, mammologist, oncologist

Work experience: 17 years

Dybenko, 13k4

m. Dybenko Street

Karapetyan Zaven Surenovich

coloproctologist, surgeon and phlebologist

Work experience: 15 years

Dunaisky, 47

Dunayskaya metro station

Marshala Zakharov, 20

Leninskiy avenue metro station

Make an appointment 90 003 Andrey Shishkin

Surgeon, phlebologist, proctologist. Candidate of Medical Sciences

Work experience: 13 years

Dunaysky, 47

Dunayskaya metro station

Make an appointment

Maslennikov Dmitry Yurievich

Surgeon, proctologist, mammologist

Work experience: 16 years

Udarnikov, 19

Ladozhskaya metro station

Dybenko, 13k4

Dybenko street metro

Make an appointment

Show more
+15 doctors

Other doctors 15 doctors

Ardashov, Pavel Sergeevich

Coloproctologist-surgeon

Work experience: 9 years

Udarnikov, 19

persons Dybenko

Make an appointment

Bulkina Maria Sergeevna

Coloproctologist, surgeon

Work experience: 11 years

Dunaysky, 47

Dunayskaya metro station

Vyborgskoe shosse, 17

Prosveshcheniya metro station 9000 3

Make an appointment

Grinevich Vladimir Stanislavovich

Surgeon, oncologist, mammologist, coloproctologist

Work experience: 27 years

Vyborgskoe shosse, 17

m.
Klyuev Andrey

Operating proctologist

Work experience: 16 years

Malaya Balkanskaya, 23

Kupchino metro station

Make an appointment

Nekrasov Roman Aleksandrovich

Coloproctologist and surgeon

Work experience: 8 years

Udarnikov, 19

Ladozhskaya metro station

Marshala Zakharov, 20

Leninsky pr. -t

Make an appointment

Petrova Vitalina Vasilievna

Operating proctologist

Work experience: 12 years

Vyborgskoe shosse, 17

Prospekt Prosveshcheniya metro station

Make an appointment

Senko Vladimir Vladimirovich

Head of the Center for Surgery and Oncology

Work experience: 23 years Leninsky Prospekt

Vyborgskoe shosse, 17

m Prospect Prosveshcheniya

Make an appointment

Sinyagina (Nazarova) Maria Andreevna

Surgeon, proctologist

Work experience: 8 years

Marshala Zakharova, 20

06
Sokolova Anna Sergeevna

Coloproctologist, surgeon. Candidate of Medical Sciences.

Work experience: 13 years

Malaya Balkanskaya, 23

Kupchino metro station

Make an appointment

Sol Anton Aleksandrovich

Work experience: 15 years

Vyborgskoye shosse, 17

metro Prosveshcheniya

Make an appointment

Fomenko Nikolai Aleksandrovich

Surgeon, proctologist, oncologist

Work experience: 15 years

Marshal Zakharova, 20

m. Leninsky pr-t

Khangireev Alexander Bakhytovich

Surgeon, oncologist, coloproctologist

Work experience: 13 years

Udarnikov, 19

Ladozhskaya metro station

Dunaiskiy, 47

Dunaiskaya metro station

Make an appointment

Khokhlov Sergey Viktorovich

Surgeon, oncologist, coloproctologist

Work experience: 28 years old

Vyborg highway, 17

m. Prospekt Prospect

Chuprina Susanna Vladimirovna

Coloproctologist of the highest category

Work experience: 22 years

Udarnikov, 19

Ladozhskaya metro station

Make an appointment

Yalda Ksenia Davidovna

Coloproctologist

Work experience: 11 years

Malaya Balkanskaya, 23

Kupchino metro station

Make an appointment

Hide the list 90 003