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Rectal prolapse occurs when part or all of the wall of the rectum slides out of place, sometimes sticking out of the anus. See a picture of rectal prolapse.
There are three types of rectal prolapse.
In severe cases of rectal prolapse, a section of the large intestine drops from its normal position as the tissues that hold it in place stretch. Typically there is a sharp bend where the rectum begins. With rectal prolapse, this bend and other curves in the rectum may straighten, making it difficult to keep stool from leaking out (fecal incontinence).
Rectal prolapse is most common in children and older adults, especially women.
Many things increase the chance of developing rectal prolapse. Risk factors for children include:
Risk factors for adults include:
The first symptoms of rectal prolapse may be:
Other symptoms of rectal prolapse include:
See a doctor if you or your child has symptoms of rectal prolapse. If it is not treated, you may have more problems. For example, the leaking stool could get worse, or the rectum could be damaged.
Your doctor will diagnose rectal prolapse by asking you questions about your symptoms and past medical problems and surgeries. He or she will also do a physical exam, which includes checking the rectum for loose tissue and to find out how strongly the anal sphincter contracts.
You may need tests to rule out other conditions. For example, you may need a sigmoidoscopy, a colonoscopy, or a barium enema to look for tumors, sores (ulcers), or abnormally narrow areas in the large intestine. Or a child may need a sweat test to check for cystic fibrosis if prolapse has occurred more than once or the cause is not clear.
Prolapse in children tends to go away on its own. You can help keep the prolapse from coming back. If you can, push the prolapse into place as soon as it occurs. You can also have your child use a potty-training toilet so that he or she does not strain while having a bowel movement.
Sometimes children need treatment. For example, if the prolapse doesn't go away on its own, an injection of medicine into the rectum may help. If the prolapse was caused by another condition, the child may need treatment for that condition.
Home treatment for adults may help treat the prolapse and may be tried before other types of treatments.
People who have a complete prolapse or who have a partial prolapse that doesn't improve with a change in diet will need surgery. Surgery involves attaching the rectum to the muscles of the pelvic floor or the lower end of the spine (sacrum). Or surgery might involve removing a section of the large intestine that is no longer supported by the surrounding tissue. Both procedures may be done in the same surgery.
Other Works Consulted
Dozois EJ, Pemberton JH (2006). Hemorrhoids and other anorectal disorders. In MM Wolfe et al., eds., Therapy of Digestive Disorders, 2nd ed., pp. 945–958. Philadelphia: Saunders.
Lembo AJ, Ullman SP (2010). Constipation. In M Feldman et al., eds., Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 9th ed., vol. 1, pp. 259–284. Philadelphia: Saunders.
Current as of: August 12, 2019
Author: Healthwise StaffMedical Review: Anne C. Poinier, MD - Internal MedicineAdam Husney, MD - Family MedicineC. Dale Mercer, MD - General Surgery
Current as of: August 12, 2019
Anne C. Poinier, MD - Internal Medicine & Adam Husney, MD - Family Medicine & C. Dale Mercer, MD - General Surgery
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