Introduction
Rectal prolapse occurs when the rectum (the last part of the large intestine) loses its normal attachments inside the body and protrudes through the anus. The prolapse can be partial, involving only the lining of the rectum (mucosal prolapse), or complete, involving the entire wall of the rectum. Rectal prolapse is more common in older adults, especially women, but can occur at any age.
Causes
The exact cause of rectal prolapse is not always clear, but several factors can contribute, including:
- Weakening of the pelvic floor muscles and ligaments that support the rectum
- Chronic constipation or straining during bowel movements
- Nerve damage in the pelvic area
- Previous surgery or injury to the pelvic region
- Conditions that increase abdominal pressure, such as chronic coughing or pregnancy
Symptoms
Symptoms of rectal prolapse may include:
- A visible bulge or mass protruding from the anus
- Feeling of incomplete bowel evacuation
- Fecal incontinence (leakage of stool)
- Mucus discharge from the anus
- Rectal bleeding
- Pain or discomfort in the anal area
Symptoms may be mild at first and worsen over time.
Diagnosis
Diagnosis is based on:
- Medical history and physical examination
- Visual inspection of the anal area, especially during straining or bearing down
- Anorectal manometry to assess the function of the anal sphincter muscles
- Sigmoidoscopy or colonoscopy to examine the rectum and colon
- Defecography (a special X-ray test) to evaluate rectal function during bowel movements
Treatment Options
Treatment depends on the severity of the prolapse and the patient’s overall health:
- Manual reduction: In some cases, the prolapsed rectum can be gently pushed back into place manually.
- Medical management: Addressing underlying conditions such as constipation or diarrhea.
- Surgery: Surgery is often needed to correct rectal prolapse. Surgical options include:
- Abdominal procedures to secure the rectum from inside the abdomen
- Perineal procedures to repair the prolapse through the anal area
The choice of surgical technique depends on the patient’s age, health, and the extent of the prolapse.
Prevention
To help prevent rectal prolapse:
- Maintain regular bowel habits and avoid constipation
- Strengthen pelvic floor muscles with exercises (Kegel exercises)
- Avoid straining during bowel movements
- Treat conditions that increase abdominal pressure, such as chronic cough
When to Seek Medical Care
Seek medical attention if you experience:
- A bulge or mass protruding from the anus
- Fecal incontinence or mucus discharge
- Rectal bleeding or pain
Takeaway
Rectal prolapse is a condition where the rectum protrudes through the anus. While it can be uncomfortable and affect bowel function, surgical treatment is often effective in correcting the problem.