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Overview

What is Rectal Prolapse?

The rectum is the last part of the large intestine that stores stool before being passed out of the body. Rectal prolapse occurs when part of the tissue that lines the rectum or the entire rectum comes out of the anus. It looks like red or pinkish-purple tissue coming from the anus. Rectal prolapse is most common in children when they are toilet training (3-4 years old). The prolapse usually moves back into the body on its own when the child stops straining.

Symptoms

Symptoms of Rectal Prolapse

The symptoms of rectal prolapse include the following:

  • Red or pinkish-purple tissue protruding from the anus
  • Pain or bleeding after stooling
  • Constipation

Diagnosis

Diagnosing Rectal Prolapse

A rectal exam will help determine if there is rectal prolapse. A picture of the suspected prolapse, taken by the caregiver, is also helpful.

A contrast enema will help to make sure there is not a rectal polyp causing the prolapse.

Testing for an underlying diagnosis that can present with rectal prolapse, such as cystic fibrosis, may also be done.

Treatment

Treatment of Rectal Prolapse

Treatment is focused on treating the underlying condition:

Constipation

A stimulant laxative is prescribed to manage constipation. We recommend limiting time spent sitting on the toilet and using a child-sized toilet seat.

This treatment needs to be followed for a few months. Most of the time the rectal prolapse resolves on its own, rectal prolapse rarely requires surgery.

Manual Reduction

Sometimes, the tissue does not go back on its own. If this happens, follow the steps below for manual reduction:

  • Place child in knees to chest position
  • Use gloves with lubricant. Place firm, gentle pressure to prolapsed rectal tissue for 5-15 minutes.
  • If the rectal tissue will not go back in, go to the emergency room.

Surgical Intervention

Rarely, rectal prolapse continues after consistent medical treatment with laxatives. If medical therapy fails, there are several treatment options. A rectopexy is a common surgical procedure to correct rectal prolapse.