Rectal Prolapse

What is rectal prolapse?

Rectal prolapse occurs when part or all of the Reference wall of the rectum Opens New Window slides out of place, sometimes sticking out of the anus. See a picture of Reference rectal prolapse Opens New Window Reference Opens New Window.

There are three Reference types of rectal prolapse Opens New Window Reference Opens New Window.

• Partial prolapse (also called mucosal prolapse). The lining (mucous membrane) of the rectum slides out of place and usually sticks out of the anus. This can happen when you strain to have a bowel movement. Partial prolapse is most common in children younger than 2 years.
• Complete prolapse. The entire wall of the rectum slides out of place and usually sticks out of the anus. At first, this may occur only during bowel movements. Eventually, it may occur when you stand or walk. And in some cases, the prolapsed tissue may remain outside your body all the time.
• Internal prolapse (Reference intussusception Opens New Window). One part of the wall of the large intestine (colon) or rectum may slide into or over another part, like the folding parts of a toy telescope. The rectum does not stick out of the anus. (See a picture of Reference intussusception Opens New Window Reference Opens New Window.) Intussusception is most common in children and rarely affects adults. In children, the cause is usually not known. In adults, it is usually related to another intestinal problem, such as a growth of tissue in the wall of the intestines (such as a Reference polyp Opens New Window or tumor).

In severe cases of rectal prolapse, a section of the Reference large intestine Opens New Window Reference Opens New Window drops from its normal position as the tissues that hold it in place stretch. Typically there is a sharp bend where the rectum begins. With rectal prolapse, this bend and other curves in the rectum may straighten, making it difficult to keep stool from leaking out (Reference fecal incontinence Opens New Window).

Rectal prolapse is most common in children and older adults, especially women.

What causes rectal prolapse?

Many conditions increase the chance of developing rectal prolapse. Risk factors for children include:

• Reference Cystic fibrosis Opens New Window. A child who has rectal prolapse with no obvious cause may need to be tested for cystic fibrosis.
• Having had surgery on the anus as an infant.
• Malnutrition.
• Deformities or physical development problems.
• Straining during bowel movements.
• Infections.

Risk factors for adults include:

• Straining during bowel movements because of constipation.
• Tissue damage caused by surgery or childbirth.
• Weakness of pelvic floor muscles that occurs naturally with age.

What are the symptoms?

The first symptoms of rectal prolapse may be:

• Leakage of stool from the anus (fecal incontinence).
• Leakage of mucus or blood from the anus (wet anus).

Other symptoms of rectal prolapse include:

• A feeling of having full bowels and an urgent need to have a bowel movement.
• Passage of many very small stools.
• The feeling of not being able to empty the bowels completely.
• Anal pain, itching, irritation, and bleeding.
• Bright red tissue that sticks out of the anus.

See a doctor if you or your child has symptoms of rectal prolapse. If it is not treated, you may have more problems. For example, the leaking stool could get worse, or the rectum could be damaged.

How is rectal prolapse diagnosed?

Your doctor will diagnose rectal prolapse by asking you questions about your symptoms and past medical problems and surgeries. He or she will also do a physical exam, which includes checking the rectum for loose tissue and to find out how strongly the Reference anal sphincter Opens New Window contracts.

You may need tests to rule out other conditions. For example, you may need a Reference sigmoidoscopy, a Reference colonoscopy, or a Reference barium enema to look for tumors, sores (ulcers), or abnormally narrow areas in the large intestine. Or a child may need a Reference sweat test to check for cystic fibrosis if prolapse has occurred more than once or the cause is not clear.

How is it treated?

Prolapse in children tends to go away on its own. You can help keep the prolapse from coming back. If you can, Reference push the prolapse into place as soon as it occurs. You can also have your child use a potty-training toilet so that he or she does not strain while having a bowel movement.

Sometimes children need treatment. For example, if the prolapse doesn't go away on its own, an injection of medicine into the rectum may help. If the prolapse was caused by another condition, the child may need treatment for that condition.

Home treatment for adults may help treat the prolapse and may be tried before other types of treatments.

• If your doctor says it's okay, you can Reference push the prolapse into place.
• Reference Avoid constipation. Drink plenty of water, and eat fruits, vegetables, and other foods that contain fiber. Changes in diet often are enough to improve or reverse a prolapse of the lining of the rectum (partial prolapse).
• Do Reference Kegel exercises to help strengthen the muscles of the pelvic area.
• Don't strain while having a bowel movement. Use a stool softener if you need to.

People who have a complete prolapse or who have a partial prolapse that doesn't improve with a change in diet will need surgery. Surgery involves attaching the rectum to the muscles of the pelvic floor or the lower end of the spine (Reference sacrum Opens New Window). Or surgery might involve removing a section of the large intestine that is no longer supported by the surrounding tissue. Both procedures may be done in the same surgery.

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This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Reference Terms of Use. Reference How this information was developed to help you make better health decisions.