What is Rectal Prolapse in Children

Rectal prolapse is the falling down or sinking of the end of the large intestine (rectum). There are two types of rectal prolapse:

• Partial. In partial rectal prolapse, the lining of the rectum falls or sinks out of place and may stick out of the anus. Partial rectal prolapse is most common in children younger than 2 years.
• Complete. In complete rectal prolapse, the wall of the rectum falls or sinks out of place and may stick out of the anus.

Rectal prolapse is most common in children aged 1–5 years. It is often discovered during toilet training after a bowel movement, when a reddish mass is seen sticking out of the anus.

What are the causes?

Rectal prolapse may be caused by:

• Constipation.
• Diarrhea.
• Frequent straining to have a bowel movement.
• Frequent coughing or vomiting.
• Cystic fibrosis.
• Malnutrition.
• Intestinal infections such as pinworms.
• Injury to the anus or pelvic area.
• A birth defect such as a spinal cord defect.
• Brain and spinal cord injuries.

Sometimes the cause may not be identified.

What are the signs or symptoms?

• A reddish mass sticking out of your child’s anus. The mass may appear inflamed, have mucus, or bleed slightly. It usually does not cause pain.
• Leaking of stool, mucus, or blood from the anus (fecal incontinence).
• Small stools.
• Pain in the anus and rectum.
• Itching or irritation in the anus.

How is this diagnosed?

To diagnose rectal prolapse, your child’s health care provider will perform a physical exam and a rectal exam. During the rectal exam, your child may be asked to strain as though having a bowel movement. Your child’s health care provider will feel the rectal area to learn about the problem. Other tests may also be performed, such as an imaging or sweat test, to find the cause or rule out possible causes.

How is this treated?

Rectal prolapse often goes away without treatment or with treatment of its cause. If the rectum is sticking out of the anus, your child’s health care provider may gently push it back in using a cloth. Rectal prolapse that does not go away may be treated with medicine in the rectum or with surgery.

Follow these instructions at home:

• Follow the health care provider’s instructions if the rectum slides out of the anus.
• Prevent constipation by making sure your child gets enough fiber. Talk to your child’s health care provider about which fiber-rich foods are safe for your child.
• If your child is training to use the toilet and is using a stand-alone toilet seat, use a seat that can be placed over the toilet instead. This kind of seat may make it easier for your child to have a bowel movement without straining.
• Follow the health care provider’s instructions about treating the cause of your child’s rectal prolapse, if one was identified.

Contact a health care provider if:

Rectal prolapse returns.