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Rectal Prolapse

By

Parswa Ansari

, MD, Hofstra Northwell-Lenox Hill Hospital, New York

Last full review/revision Feb 2021| Content last modified Feb 2021
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Topic Resources

Rectal prolapse is a painless protrusion of the rectum through the anus.

  • A rectal prolapse is often caused while straining, such as during a bowel movement.

  • The diagnosis is based on an examination and various viewing and imaging tests.

  • Rectal prolapse in infants and children usually heals without surgery.

  • Rectal prolapse in adults is treated surgically.

The rectum is the section of the digestive tract above the anus where stool is held before it passes out of the body through the anus. The anus is the opening at the end of the digestive tract where stool leaves the body. (See also Overview of the Anus and Rectum Overview of the Anus and Rectum The anus is the opening at the end of the digestive tract where stool leaves the body. The rectum is the section of the digestive tract above the anus where stool is held before it passes out... read more .)

The Digestive System

Locating the Rectum and Anus

Prolapse is when an organ slips out of its normal position in the body. Rectal prolapse causes the rectum to turn inside out, so that the rectal lining (rectal mucosa) is visible outside the body as a dark red, moist, fingerlike projection from the anus. Bleeding from the rectum can occur, and an uncontrolled loss of stool (fecal incontinence Fecal Incontinence Fecal incontinence is the loss of control over bowel movements. Fecal incontinence can occur briefly during bouts of diarrhea or when hard stool becomes lodged in the rectum (fecal impaction)... read more ) is a frequent symptom. Less commonly, the rectum protrudes into the vagina (rectocele Rectocele Pelvic organ prolapse involve a dropping down (prolapse) of the bladder, urethra, small intestine, rectum, uterus, or vagina caused by weakness of or injury to the ligaments, connective tissue... read more Rectocele ). This disorder causes pain only when complications occur or when the prolapse is severe.

A temporary prolapse of only the rectal lining often occurs in otherwise healthy infants, probably when the infant strains during a bowel movement, and is rarely serious. In adults, prolapse of the rectal lining tends to persist and may worsen, so that more of the rectum protrudes.

A complete prolapse of the rectum (sometimes formally called procidentia, but this term can refer to any complete organ prolapse) occurs most often in women older than age 60.

Diagnosis of Rectal Prolapse

  • A doctor's examination

  • Sigmoidoscopy, colonoscopy, or barium enema x-rays

To determine the extent of a prolapse, a doctor examines the area while the person is standing or squatting and straining. By feeling the anal sphincter with a gloved finger, a doctor often detects diminished muscle tone.

Treatment of Rectal Prolapse

  • Elimination of causes of straining

  • For infants and children, strapping the buttocks together

  • For adults, usually surgery

In infants and children, a stool softener eliminates the urge to strain. Strapping the buttocks together between bowel movements usually helps the prolapse heal on its own.

In adults, surgery is usually needed to correct the problem. During one kind of abdominal operation (called rectopexy), the entire rectum is lifted, pulled back, and attached to the sacral bone in the pelvis. In another operation, a segment of the rectum is removed, and the remainder of the rectum is stitched to the sacral bone.

For people who are too weak to undergo surgery on the abdomen, surgery on the rectum is preferred.

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