What Is Rectal Prolapse

Rectal prolapse is the displacement of the rectum from its normal position, resulting in its protrusion through the anus.

  • Straining to make bowel movements is the usual cause.
  • Physical examination, sigmoidoscopy and x-rays help in diagnosis.
  •  Infants and young children may have prolapse of the rectal lining which heals    without treatment
  • Surgery may be required to correct the rectal prolapse occurring in adults.

The prolapsed part of the rectum may be visible as a finger-like bulge in the anus. It appears darker red in color and moist to touch because it is the inner wall of the rectum that is being visible. Urinary incontinence and bleeding are the usual symptoms. Occasionally, a rectal prolapse may bulge into the vagina causing pain during sex.

In infants, the lining of the rectum may temporarily prolapse due to straining while emptying the bowels; it usually resolves without treatment. The rectal prolapse in adults steadily worsens resulting in more portion of the rectum bulging out into the anus. Procidentia is a condition mainly occurring in older women in which the rectum is completely prolapsed.

A physical examination of the anus and rectum with the patient in a squatting position, or sitting as if straining to empty the bowels, helps the doctor assess the extent to which the rectum has prolapsed. The muscle tone of the anal sphincter can be judged by feeling the sphincter with a gloved finger.

Further tests such as barium enema x-rays and viewing the anus and rectum with a sigmoidoscope may help determine the reason and extent of prolapse. A colonoscopy also may be done to view the interiors of the large intestine.

Treatment

Using stool softeners is a standard part of the treatment to prevent straining while passing the bowels. Binding together of the buttocks, between subsequent bowel movements, may help the rectal prolapse in infants and children to heal.

Surgical correction is the usual treatment for rectal prolapse in adults, especially for those suffering from procidentia. During an abdominal surgery, the supporting tissue is pulled up to bring the rectum back into normal position, and then it is tied to the sacral bone. In another type of surgery, the prolapsed part of the rectum is surgically removed and the remaining parts are stitched together and attached to the sacral bone to keep it in place.

Since an abdominal surgery has its own risks and the older people who need surgical correction may not be suitable candidates for such major surgeries, rectal surgery is often preferred to the former. Thiersch procedure is a technique in which a plastic loop is fitted around the sphincter to prevent prolapse. Surgical removal of the prolapsed portion is also a fairly common practice.

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Yasser Elnahas

MD, PHD, Professor Of CardioVascular Surgery
Dr. Yasser Elnahas, Is an associate Professor of Cardiovascular Surgery. Dr. Elnahas was trained as a fellow At Texas Heart Institute And Mayo Clinic Foundation.Dr. Elnahas is dedicated to educating the general public about different disease conditions and simplifying the medical knowledge in an easy to understand terminology.

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One Response to What Is Rectal Prolapse

  1. Leonard Curtis says:

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