A rectal prolapse occurs when the rectum, the last part of the large intestine, slips out of its normal position and protrudes through the anus. It can cause pain, discomfort, bleeding, and difficulty with bowel movements. Rectal prolapse isn't life-threatening, but it can have serious consequences if left untreated. We'll discuss the causes, symptoms, diagnosis, treatment, and prevention of rectal prolapse in this blog post.
The exact cause of rectal prolapse is not clear, but it is thought to be related to a weakening of the muscles and ligaments that support the rectum and the pelvic floor. Some factors that may increase the risk of rectal prolapse include:
Aging, as the muscles and tissues tend to lose strength and elasticity over time.
Pregnancy and childbirth, as they can stretch and damage the pelvic floor muscles and nerves.
Chronic constipation or diarrhea, as they can cause repeated straining and pressure on the rectum.
Intestinal parasite infections, such as pinworms, that can irritate the rectum and cause inflammation.
Chronic coughing or sneezing, as they can increase the abdominal pressure and push the rectum downward.
Spinal cord or nerve damage, such as from injury, surgery, or diseases like multiple sclerosis, that can affect the nerve signals to the rectum and the pelvic floor muscles.
Cystic fibrosis, a genetic disorder that causes thick mucus to build up in the lungs and digestive system, and can lead to chronic lung infections and malnutrition.
The symptoms of rectal prolapse may vary depending on the severity and type of the condition. There are three main types of rectal prolapse:
In internal prolapse, the rectum drops inside the anus without pulling out completely. It may not cause any symptoms, but it may cause the sensation of incomplete elimination after a bowel movement.
An instance of mucosal prolapse occurs when only the inner lining of the rectum emerges from the anus, causing a reddish, moist, and circular protrusion. This can cause pain, itching, or irritation.
The rectum will come out of the anus completely. This may cause a large, soft, and doughy mass to hang out of the anus. It may also cause pain, bleeding, mucus discharge, fecal incontinence, constipation, or infection.
In order to diagnose rectal prolapse, your doctor will ask you about your medical history, symptoms, and bowel habits. Additionally, they will inspect your anus and rectum, and request that you strain or push as if you were having a bowel movement during the physical exam. Your rectum and anus may also be examined with an anoscope or proctoscope.
Your doctor may also order some tests to rule out other conditions that may cause similar symptoms, such as hemorrhoids, anal fissures, or rectal cancer. These tests may include:
Blood tests, to check for anemia, infection, or inflammation.
Stool tests, to check for parasites, bacteria, or blood.
Colonoscopy, where a thin, flexible tube with a camera is inserted through the anus and into the colon, to examine the entire large intestine and take biopsies if needed.
Anorectal manometry, where a small tube with a balloon is inserted into the rectum, to measure the pressure and coordination of the rectal and anal muscles.
Defecography, where a contrast material is injected into the rectum, and then X-rays are taken while you have a bowel movement, to show how the rectum and anus function.
Pelvic floor MRI, where a magnetic resonance imaging (MRI) scan is used to create detailed images of the pelvic organs and muscles.
The treatment of rectal prolapse depends on the type, severity, and symptoms of the condition, as well as your age, health, and preferences. The main treatment options are:
Nonsurgical treatment may include lifestyle changes, medications, and pelvic floor exercises. If you are overweight or obese, lifestyle changes may include increasing your fluid and fiber intake, avoiding straining and constipation, treating coughs and infections, and losing weight. Medications may include stool softeners, laxatives, or antiparasitic drugs. Exercises that strengthen your pelvic floor muscles, also known as Kegel exercises, may be recommended. People who are not good candidates for surgery or who have mild rectal prolapse may benefit from nonsurgical treatment.
Surgery involves repairing or removing the prolapsed rectum and restoring it to normal. Rectal prolapse can be treated with a variety of surgical procedures, such as abdominal surgery, where the rectum is accessible through an incision in the abdomen, or perineal surgery, which accesses the rectum through the anus or the perineum (between the anus and the genitals). Surgery may be recommended based on a number of factors, including the extent of the prolapse, the condition of the rectum and pelvic floor muscles, the risk of complications, and the recovery period. Although surgery is usually the most effective and definitive treatment for rectal prolapse, it can also have some risks and side effects, including bleeding, infection, nerve damage, recurrence, or changes in bowel function.
Rectal prolapse may not be completely preventable, but you can take some steps to reduce your risk of developing or worsening the condition, such as:
Eating a balanced and high-fiber diet, to prevent constipation and promote regular bowel movements.
Drinking plenty of fluids, to keep your stools soft and easy to pass.
Avoiding straining or holding your breath when you have a bowel movement, to reduce the pressure on your rectum and anus.
Treating any underlying conditions that may cause chronic coughing, diarrhea, or nerve damage, such as asthma, allergies, irritable bowel syndrome, or diabetes.
Practicing good hygiene and washing your hands frequently, to prevent infections and parasites that may irritate your rectum.
Doing pelvic floor exercises regularly, to strengthen the muscles that support your rectum and the pelvic organs.
Seeking medical attention if you notice any signs or symptoms of rectal prolapse, to get an early diagnosis and treatment.
Rectal prolapse occurs when the rectum slips out of its normal position and protrudes through the anus. Rectal prolapse can cause discomfort, pain, bleeding, and difficulty with bowel movements. Although it is not a life-threatening condition, it can affect your quality of life and lead to complications if left untreated. Rectal prolapse can be treated differently depending on its type, severity, symptoms, your age, your health, and your preferences. Surgical or nonsurgical treatment options include repairing or removing the prolapsed rectum and restoring it to its normal position, as well as lifestyle changes, medications, and pelvic floor exercises. There may not be a way to completely prevent rectal prolapse, but there are some things you can do to reduce your risk of developing or worsening the condition, including eating a high-fiber diet, avoiding straining, treating any underlying conditions, practicing good hygiene, and exercising your pelvic floor. For more information and advice about rectal prolapse, please consult your doctor.
