Rectal prolapse can be embarrassing and painful, but it is treatable.
The rectum is the lower part of the large intestine that lets stool out of the body through the anus. When the lining of the rectum becomes loose and either folds down into itself or pushes out through the anus, this is known as rectal prolapse.
Depending on the cause and the severity of the prolapse, various treatment methods may be considered, ranging from dietary changes to surgery.
There are several reasons as to why prolapse may occur in the rectum. The most common cause of rectal prolapse is due to straining from constipation. Bearing down too hard in an attempt to have a bowel movement can put too much strain on the lining of the rectum, resulting in prolapse. Another possible cause of loosening and slippage of the rectal lining is due to damage to the tissues caused during childbirth or surgery. Over time, the weakening of the muscles in the pelvic floor may also lead to rectal prolapse.
Problems with the sigmoid colon, the anal sphincter, and the tissue that supports the rectum may also lead to prolapse. Other causes that occur more commonly in children are malnutrition or certain types of infection. Children who have cystic fibrosis also appear to be at greater risk for developing this condition.
The most obvious symptom of rectal prolapse is the appearance of bright red tissue pushing out of the anus, which is the lining of the rectum. However, those with partial prolapse may not notice tissue exposed from the rectum. At first, there may be issues with bowel movements. Some individuals may begin to notice fecal incontinence. Wet anus, or leaking of blood or mucus from the anus, is another symptom that could signal rectal prolapse in its early stages.
Other symptoms related to this condition include feelings of bowel fullness, feelings of inability to completely empty the bowels, or many small bowel movements. Some patients notice more difficulty in the anal area, such as itching, pain, or even bleeding.
A physical examination may alert the physician to rectal prolapse. However, without obvious signs such as rectal tissue pushing out of the anus, the physician may need to rule out other medical conditions before a diagnosis of prolapse is made. This can be done through visual inspection within the lower bowels.
If rectal prolapse is caused by straining from constipation, the physician may recommend that the patient drink more fluids and eat foods that are high in fiber. A laxative or stool softener may also be recommended. If the problem is due to a weakening of the pelvic floor muscles, Kegel exercises may strengthen the region to prevent future prolapse. In children, an injection into the rectum might help.
In cases that do not resolve on their own, through dietary changes, or with exercise, surgery may be necessary. During surgery, any excess lining may be removed. The remaining tissue will be surgically attached through an incision made with through the perineum or through the abdomen.