Rectal Prolapse

Rectal prolapse is when the lowest part of the large intestine, called the rectum [REK-tum] slips out of the anus. With this condition, the rectum comes out of the anus inside-out.

Rectal prolapse can make it difficult to hold your bowel movements. This can be uncomfortable and embarrassing, but most of the time it does not turn into a major medical situation.

In some cases, rectal prolapse can be treated with laxatives or stool softeners, but most of the time it needs to be fixed with surgery.

In most cases, the onset of a rectal prolapse happens over time. In the early stages, the prolapse will fall out as a bowel movement is passed and return to its proper place once the bowel movement is complete. Over time, the prolapse may not return to place on its own, and the patient may have to push it back into place. As the prolapse persists, the rectal mucus may become thicker and bleed a lot. Rarely, the prolapse can become stuck outside the anus. If this happens, surgery is most likely needed to fix it.

Rectal prolapse is not very common. It affects mostly adult (over age 50) women. Although very rare, it still may happen in younger people. If it is happening in someone younger, or a child, they should see a doctor. In some cases, if rectal prolapse is found in younger people, it may also appear with other conditions, such as autism, or psychiatric problems that may need treatment. 

Most of the time, rectal prolapse is self-diagnosable. Rectal prolapse can make it difficult to hold your bowels, which can make it feel as though the stools are leaking out of the anus. It can be especially difficult to hold your stools if you are having gas.

Other symptoms may include:

• Constipation
• Leaky stools
• Anal itchiness
• Discharge from the anus
• A bumpy anus
• A mass protruding from the anus

In most cases of rectal prolapse, it may be good to see a doctor if your stools become too embarrassing or difficult to hold. Your doctor can help you create a treatment plan.

Although doctors aren’t sure what exactly causes a rectal prolapse, there are some things that are linked to this condition. Some of these factors include:

• Chronic constipation
• In women, giving birth by vaginal delivery, especially more than once

Your doctor may perform a physical exam to help figure out how severe the rectal prolapse is, and also help decide on a treatment plan. Your doctor may also order a colonoscopy [COL-uhn-AHS-kuh-PEE] to rule out other, sometimes more severe, medical problems.

Treatments for rectal prolapse range from self-care to surgery. Most people that try self-treatment will likely need surgery later, and self-treatment usually just allows a patient to go longer without needing surgery.

Self-care treatments may include:

• Kegel exercises
• Dietary fiber
• Supportive clothing

There are also surgical options. The two most common are surgery from the perineum [PAIR-en-EE-um], or surgery from the abdomen.

Surgery from the perineum is where the rectum is surgically pressed back in from the bottom. Surgery from the abdomen is where the prolapse is pulled back in through the abdomen. Most of the time, both types of surgery are effective and result in a major increase in the patient’s quality of life. The choice of procedure depends on the other symptoms you may be having. Talk to your doctor about both options to figure out with one will be the best for you.

As doctors do not fully understand the cause of rectal prolapse, there are no proven ways to prevent it. Rectal prolapse is often linked to constipation, so it may be helpful to avoid this by eating a high fiber diet and exercising regularly. If you find you are having problems passing your stools, talk to your doctor to make sure it does not progress to rectal prolapse.

Rectal prolapse is when the lowest part of the large intestine, called the rectum [REK-tum] slips out of the anus. It can make it difficult to hold in your bowel movements. Most of the time, surgery is needed to fix it.