What Is Rectal Prolapse? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Rectal prolapse occurs when part or all of the rectum slides out of place and sticks out of the anus, turning the rectum inside out.

The rectum is the final section of the large intestine before the anus (the opening through which stool passes out of the body).

Rectal prolapse is an uncomfortable condition that usually requires surgery to fix.

直肠脱垂可能be uncomfortable, but it’s not usually painful.

Symptoms of rectal prolapse may include:

• Bright red tissue sticking out of the anus (the tissue might be bloody or havemucuson it, and it may move back inside the body on its own or stay outside the anus)
• An uncomfortable sensation like something is falling out, or like you’re sitting on a ball
• Trouble beginning abowel movement
• Feeling like you can’t completely empty your bowels
• Fecalincontinence(inability to control your bowel movements; feces may leak out unexpectedly)

There’s no single definitive cause of rectal prolapse, although a number of known factors can increase your risk of developing this condition.

• Chronicconstipation(difficult bowel movements that happen less than three times in a week)
• Chronic diarrhea (bowel movements are watery or runny, and happen more than three times a day on a regular basis)
• History of straining during bowel movements
• Weak muscles in the pelvic area
• Being of older age (muscles in the area weaken with age)
• 先前的损伤肛门或骨盆
• Nerve damage (may be due to pregnancy, difficult vaginal birth, paralysis of the anal sphincter, spinal injury, or back injury)

Or they may also administer or order the following tests:

• DefecogramX-rays taken during a bowel movement examine muscle movement.
• Anorectal manometryA thin tube is used to measure the strength of the sphincter.
• ColonoscopyA tube with a camera is used to examine the colon.
• Anal sphincter electromyography (EMG)An electrode measures sphincter muscle activity.
• MRIThis test can help assess organs used during a bowel movement.

Prognosis of Rectal Prolapse

Prognosis tends to be good. If surgery is needed, it has a high success rate and usually cures the prolapse.

Related:11 Tips for Better Digestive Health

Treatment for rectal prolapse depends on the severity of your symptoms. Sometimes prolapses resolve on their own. Initially your healthcare provider might work with you to manage the constipation that might be causing the prolapse through adding fiber to your diet and keeping hydrated. Your doctor might work with you to avoid straining during bowel movements. Kegel exercises to strengthen the pelvic muscles might also be advised.

If none of these strategies help, surgery is usually required — especially if you’re experiencing recurrent episodes.

Surgery can keep rectal prolapse from happening again. Two types of surgical procedures are typically used to treat rectal prolapse:

• Abdominal repairSurgery to fix rectal prolapse is usually done through the belly. Abdominal surgery for rectal prolapse usually involves making a small cut in the lower abdomen. The surgeon will then pull the rectum upward and attach it to a small bone in the lower back so that it can’t slip out again.
• Rectal repairIn this type of surgery, the surgeon works through the anus rather than making an incision in the abdomen. This surgery is often performed on older patients or those with more medical problems.

The two most common rectal procedures are:

• Altemeier procedureIn this procedure, the surgeon cuts off or removes a portion of the rectum that extends outside the anus. The remaining rectum is pushed back inside the body and attached to the inside of the anus.
• Delorme procedureIn this procedure, the inner lining of the fallen rectum is removed. The outer lining is then folded and sewn back so that it no longer protrudes.

Prevention of Rectal Prolapse

To prevent rectal prolapse, avoid straining during bowel movements.

• Drink plenty of water
• Eat fruits, vegetables, and other foods that are high in fiber
• Exercise regularly
• Uselaxativesbut only as directed by your healthcare provider because of the potential risks of chronic use
• Consider bowel training, which involves having a bowel movement at the same time each day

• Ulcersin the rectum. These can lead to bleeding.
• A prolapse that can’t be pushed back into the rectum. Emergency treatment is necessary in this case because the blood supply to the prolapse will be cut off, resulting in pain.
• Damage to the muscles and nerves in the sphincter. These can worsen fecal incontinence.

• Cystic fibrosis
• Chronic obstructive pulmonary disease (COPD)
• Hysterectomy
• Infections in the intestines
• Diseases caused by an inability to properly digest food

The website for theAmerican Society of Colon and Rectal Surgeonsprovides a detailed and thorough guide for this condition.

Additional reporting byAbbi LibersandCarlene Bauer.