What is Rectal Prolapse?

Rectal prolapse is when part of the tissue that lines the rectum or the entire rectum comes out of the anus. It looks like beefy red or pinkish-purple tissue coming from the anus.

It 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.

Why Does Rectal Prolapse Happen?

  • Constipation -  This is the most common cause of rectal prolapse. The stool is too hard, it is difficult to get out, and/or a bowel movement happens less than 3 times a week. It is often the result of excessive straining on the toilet.
  • Diarrhea - Bowel movements are watery or runny and happen more than 4 times a day over many days.
  • Spinal cord or brain problems: Problems with the spine or brain may cause weakness in the muscles of the pelvis or anus.
  • Cystic Fibrosis - Cystic Fibrosis causes very thick and bulky stools that are difficult to pass.

Is There a Test for Rectal Prolapse?

No. A rectal exam will help determine if there is rectal prolapse. A picture may be taken by the caregiver, which demonstrates the finding, is also helpful. 

A contrast enema will help to make sure there is not a rectal polyp causing the prolapse. A test for cystic fibrosis should be done.

How is Rectal Prolapse Treated?

Treatment is focused on treating the underlying condition:

Constipation

  • A stimulant laxative to manage constipation
  • Limit time spent sitting on the toilet
  • Use a child-size 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 (if the tissue does not go in on its own)

  • 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.

Rectopexy

  • If rectal prolapse continues after trying medical treatment with laxatives, the child may require a surgery. It is called a rectopexy.

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