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Rectal Prolapse

By

Parswa Ansari

, MD, Hofstra Northwell-Lenox Hill Hospital, New York

Last full review/revision Jan 2020| Content last modified Jan 2020
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Topic Resources

Rectal prolapse is a painless protrusion of the rectum through the anus.

  • A rectal prolapse is often caused while straining, such as during a bowel movement.

  • The diagnosis is based on an examination and various viewing and imaging tests.

  • Rectal prolapse in infants and children usually heals without surgery.

  • Rectal prolapse in adults is treated surgically.

The rectum is the section of the digestive tract above the anus where stool is held before it passes out of the body through the anus. The anus is the opening at the end of the digestive tract where stool leaves the body. (See also Overview of the Anus and Rectum.)

The Digestive System

The Digestive System

Prolapse is when an organ slips out of its normal position in the body. Rectal prolapse causes the rectum to turn inside out, so that the rectal lining (rectal mucosa) is visible outside the body as a dark red, moist, fingerlike projection from the anus. Bleeding from the rectum can occur, and an uncontrolled loss of stool (fecal incontinence) is a frequent symptom. Less commonly, the rectum protrudes into the vagina (rectocele). This disorder causes pain only when complications occur or when the prolapse is severe.

A temporary prolapse of only the rectal lining often occurs in otherwise healthy infants, probably when the infant strains during a bowel movement, and is rarely serious. In adults, prolapse of the rectal lining tends to persist and may worsen, so that more of the rectum protrudes.

A complete prolapse of the rectum (sometimes formally called procidentia, but this term can refer to any complete organ prolapse) occurs most often in women older than age 60.

Diagnosis

  • A doctor's examination

  • Sigmoidoscopy, colonoscopy, or barium enema x-rays

To determine the extent of a prolapse, a doctor examines the area while the person is standing or squatting and straining. By feeling the anal sphincter with a gloved finger, a doctor often detects diminished muscle tone.

A sigmoidoscopy, colonoscopy, or barium enema x-rays of the large intestine may reveal an underlying disease.

Treatment

  • Elimination of causes of straining

  • For infants and children, strapping the buttocks together

  • For adults, usually surgery

In infants and children, a stool softener eliminates the urge to strain. Strapping the buttocks together between bowel movements usually helps the prolapse heal on its own.

In adults, surgery is usually needed to correct the problem. During one kind of abdominal operation (called rectopexy), the entire rectum is lifted, pulled back, and attached to the sacral bone in the pelvis. In another operation, a segment of the rectum is removed, and the remainder of the rectum is stitched to the sacral bone.

For people who are too weak to undergo surgery on the abdomen, surgery on the rectum is preferred.

NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version
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