Rectal Prolapse

What is Rectal Prolapse

Rectal prolapse happens when the inside of the final section of the large intestine (rectum) pushes out through the anal opening. With this condition, the lower part of the rectum turns inside out.

At first, rectal prolapse may be temporary. It may happen only when you are having a bowel movement. Over time, the prolapse will likely get worse. It may start to happen more often and cause uncomfortable symptoms.

Eventually, the prolapse may happen when you are walking or simply standing. Surgery is often needed for this condition.

What are the causes?

This condition may result from weakness of the muscles that attach the rectum to the inside of the lower abdomen. The exact cause of this muscle weakness is not known.

What increases the risk?

This condition is more likely to develop in:

  • Women who are 50 years of age or older.
  • People with a history of constipation.
  • People with a history of hemorrhoids.
  • People who have a lower spinal cord injury.
  • Women who have been pregnant many times.
  • People who have had rectal surgery.
  • Men who have an enlarged prostate gland.
  • People who have chronic obstructive pulmonary disease (COPD).
  • People who have cystic fibrosis.

What are the signs or symptoms?

The main symptom of this condition is a red bump of tissue sticking out from your anus. At first, the bump may only appear after a bowel movement. It may then start to appear more often. Other symptoms may include:

  • Discomfort in the anus and rectum.
  • Constipation.
  • Diarrhea.
  • Inability to control bowel movements (incontinence).
  • Rectal bleeding.

How is this diagnosed?

This condition may be diagnosed based on your symptoms and a physical exam. During the exam, you may be asked to squat and strain as though you are having a bowel movement. You may also have tests, such as:

  • A rectal exam using a flexible scope (sigmoidoscopy or colonoscopy).
  • A procedure that involves taking X-rays of your rectum after a dye (contrast material) is injected into the rectum (defecogram).

How is this treated?

This condition is usually treated with surgery to repair the weakened muscles and to reconnect the rectum to attachments inside the lower abdomen. Other treatment options may include:

  • Pushing the prolapsed area back into the rectum (reduction). Your health care provider may do this by gently pushing it back in using a moist cloth. The health care provider may also show you how to do this at home if the prolapse occurs again.
  • Medicines to prevent constipation and straining. This may include laxatives or stool softeners.

Follow these instructions at home:

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Do not strain to have a bowel movement.
  • Do not lift anything that is heavier than 10 lb (4.5 kg).
  • Follow instructions from your health care provider about what to do if the prolapse occurs again and does not go back in. This may involve lying on your side and using a moist cloth to gently press the lump into your rectum.
  • Keep all follow-up visits as told by your health care provider. This is important.

Preventing Constipation

  • Eat foods that have a lot of fiber, such as fruits, vegetables, whole grains, and beans.
  • Limit foods high in fat and processed sugars, such as french fries, hamburgers, cookies, candies, and soda.
  • Drink enough fluids to keep your urine clear or pale yellow.

Contact a health care provider if:

  • You have a fever.
  • Your prolapse cannot be reduced at home.
  • You have constipation or diarrhea.
  • You have mild rectal bleeding.

Get help right away if:

  • You have very bad rectal pain.
  • You bleed heavily from your rectum.
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