The last part of the large intestine or colon which joins the anus is known as the rectum. Prolapse of the rectum occurs when a part of the wall or entire wall of the rectum slides or slips out through the anus. Normally, the lining is tethered, preventing it from sticking out of the anus, prolapse essentially turns the rectum inside out with straining and defecation.
Rectal prolapse is more common in women especially after age 50 (6 fold increased risk compared to men). It is often mistaken for hemorrhoids. Rectal prolapse may be internal where the lining starts to drop or slide but no part of the slide is outside the anus, partial where a part of the lining protrudes out of the anus or complete with the entire rectum protruding out of the anus.
- Constipation, chronic and excessive straining due to constipation is the cause of rectal prolapse in one third to two thirds of all patients with rectal prolapse.
- Diarrhea causes rectal prolapse in up to 15% of patients with rectal prolapse.
- Nerve and muscle damage or weakened anal sphincter from:
- Pregnancy and Childbirth.
- Spinal injury or disease.
- Pelvic or rectal surgery.
- Increased age.
Symptoms can come on slowly with the perception of a bulge at the anus or seem like one is sitting on a ball. Triggers for causing the rectum to prolapse besides straining include walking, sitting and exercising. During the initial stages, it may be reinserted or returned back into the rectum by hand.
- Rectal bleeding.
- Leakage of solid or liquid bowel movement and gas from your rectum.
- Sensation of rectal fullness with an urge to have a bowel movement with little to no stool on attempts to defecate.
- Small and frequent bowel movements.
- Sensation of not being able to empty or evacuate the bowels completely.
- Anal pain, itching, or irritation.
Severity of prolapse can range from mild to severe. Severe cases may require surgery to pull the rectum back up and into its proper position and ensure that it doesn’t slip back outside. Mild cases can be treated with:
- Fiber supplementation with diet or supplements.
- Stool softeners, suppositories or laxatives.
- Medications to treat the cause of prolapse.
Rectal prolapse is a condition in which the rectum (the last part of the large intestine) becomes displaced and protrudes from the anus. It can occur in both adults and children.
The main symptom of rectal prolapse is the protrusion of tissue from the anus, which may be noticeable during bowel movements or at other times. Other symptoms may include difficulty controlling bowel movements, rectal bleeding, rectal pressure and pain, sensation of incomplete evacuation of the rectum, and anal itching or pain.
Rectal prolapse can be caused by a variety of factors, including chronic constipation, straining during bowel movements, and weakening of the muscles and tissues supporting the rectum. It can also be a complication of certain medical conditions, such as multiple sclerosis or spinal cord injury.
Rectal prolapse is usually diagnosed based on the patient’s symptoms and a physical examination. Further testing, such as a rectal exam or imaging tests, may be necessary to confirm the diagnosis and assess the extent of the prolapse.
Treatment for rectal prolapse will depend on the severity of the prolapse and the specific needs of the patient. Options may include lifestyle changes to manage constipation and other contributing factors, medication to control symptoms, or surgery to repair the prolapse.
In some cases, rectal prolapse can be prevented or minimized by maintaining good bowel habits, such as getting regular exercise, eating a high-fiber diet, and avoiding straining during bowel movements. It is also important to manage any underlying medical conditions that may contribute to rectal prolapse.