What is rectal prolapse? What causes it? What are the symptoms of rectal prolapse? How is rectal prolapse diagnosed and treated?

What is Rectal Prolapse?

Rectal prolapse occurs when part or all of the wall of the rectum slides out of place, sometimes sticking out of the anus. There are three types of rectal prolapse:

1. Partial prolapse (mucosal prolapse): The lining (mucous membrane) of the rectum slides out of place and usually sticks out of the anus. This can happen when you strain to have a bowel movement.
2. Complete prolapse: The entire wall of the rectum slides out of place and usually sticks out of the anus. At first, this may occur only during bowel movements, but eventually, it may occur when you stand or walk.
3. Internal prolapse (intussusception): One part of the wall of the large intestine (colon) or rectum may slide into or over another part, like the folding parts of a toy telescope. The rectum does not stick out of the anus.

What Causes Rectal Prolapse?

Several factors can increase the risk of developing rectal prolapse:

Causes in Children

• Cystic fibrosis
• Previous surgery on the anus as an infant
• Malnutrition
• Developmental problems
• Straining during bowel movements
• Infections

Causes in Adults

• Straining during bowel movements due to constipation
• Tissue damage caused by surgery or childbirth
• Weakening of pelvic floor muscles with age

What are the Symptoms of Rectal Prolapse?

The first symptoms of rectal prolapse may include:

• Fecal incontinence (leakage of stool from the anus)
• Leakage of mucus or blood from the anus (wet anus)

Other symptoms of rectal prolapse include:

• A feeling of having full bowels and an urgent need to have a bowel movement
• Passage of many very small stools
• The feeling of not being able to empty the bowels completely
• Anal pain, itching, irritation, and bleeding
• Bright red tissue that sticks out of the anus

How is Rectal Prolapse Diagnosed?

To diagnose rectal prolapse, your doctor will:

• Ask about your symptoms and medical history
• Perform a physical examination, including checking the rectum for loose tissue and the strength of the anal sphincter
• Order tests such as a sigmoidoscopy, colonoscopy, or barium enema to rule out other conditions
• In some cases, a child may need a sweat test to check for cystic fibrosis if the cause is not clear

How is Rectal Prolapse Treated?

The treatment for rectal prolapse depends on the type and severity of the condition:

Treatment for Children

In many cases, rectal prolapse in children goes away on its own. However, if the prolapse doesn’t go away or is caused by another condition, the child may need additional treatment, such as:

• Pushing the prolapse back into place
• Avoiding straining during bowel movements by using a potty-training toilet
• Injections of medicine into the rectum
• Treatment for the underlying condition (e.g., cystic fibrosis)

Treatment for Adults

Home treatment for adults may help treat the prolapse and may be tried before other types of treatments:

• Pushing the prolapse back into place (if your doctor says it’s okay)
• Avoiding constipation by drinking plenty of water and eating high-fiber foods
• Doing Kegel exercises to strengthen the pelvic floor muscles
• Avoiding straining during bowel movements and using stool softeners if needed

If home treatment is not effective, your doctor may recommend other treatments, such as surgery, to help correct the prolapse.

Preventing Rectal Prolapse

To help prevent rectal prolapse, it’s important to maintain good bowel habits and avoid straining during bowel movements. This includes:

• Drinking plenty of water
• Eating a high-fiber diet
• Using the restroom regularly and avoiding holding in bowel movements
• Performing Kegel exercises to strengthen the pelvic floor muscles

If you or your child is experiencing symptoms of rectal prolapse, it’s important to see a healthcare provider for proper diagnosis and treatment. Timely intervention can help prevent the condition from worsening and reduce the risk of complications.