Rectal prolapse


1. What is rectal prolapse?

2. Prognosis of the disease

3. Symptoms

4. Medical tests

5. Causes

6. Can it be prevented?

7. Treatments

8. Which specialist treats it?

What is rectal prolapse?

Rectal prolapse is a condition that occurs when the end of the large intestine, known as the rectum, protrudes downward and out through the anus. The rectum is at the end of the large intestine and represents the area where stool collects before passing through the anus with a bowel movement.

The rectum is made up of three layers: the rectal lining of the wall (mucous membrane), a layer of muscle and a layer of fatty tissue surrounding the rectum (mesorectum). If the wall of the rectum protrudes through the anus, it is a rectal prolapse.

The three types of rectal prolapse are

  • Complete rectal prolapse: this is the most common type and occurs when the wall of the rectum protrudes through the anus.
  • Mucosal prolapse — occurs when the lining of the rectum protrudes through the anus.
  • Internal rectal prolapse — the rectum folds in on itself, but does not protrude through the anus.

Prognosis of the disease

In cases where rectal prolapse is not adequately treated, constipation may occur, as well as loss of bowel control. However, in most cases prolapse can be cured by surgical intervention.

Symptoms of rectal prolapse

The most common symptom of rectal prolapse is characterized by leakage of tissue from the anal canal. If the prolapse worsens, it may also protrude when coughing, sneezing or standing up.

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Other symptoms of a rectal prolapse include:

  • Difficulty controlling bowel movements
  • Bleeding
  • Ulceration
  • Itching
  • Pain
  • Fecal incontinence

Medical tests for rectal prolapse

Rectal prolapse is diagnosed through a rectal examination. However, there is a possibility that additional tests may be needed, which may include defecography, colonoscopy, or anorectal manometry.

What are the causes of rectal prolapse?

A rectal prolapse is often associated with weak muscles in the pelvis, i.e. the pelvic floor. These are triggered by pregnancy, constipation, diarrhea and coughing due to conditions such as cystic fibrosis or whooping cough.

As women age, rectal prolapse can occur at the same time as uterine or bladder prolapse because the pelvic floor muscles weaken over time or weaken after childbirth.

Can it be prevented?

Rectal prolapse can be prevented by avoiding constipation, by eating high-fiber foods, or by taking laxatives.

Treatments for rectal prolapse

In children, rectal prolapse usually improves without any treatment. In adults, it is advisable to avoid constipation by eating high-fiber foods or taking laxatives.

Surgery may be offered as a treatment depending on the type of prolapse, the patient’s age and a history of medical problems.

There are two types of surgery:

  • Abdominal surgery: involves making a cut in the abdomen and is only used for full-thickness prolapse.
  • Perineal surgery: involves cutting the prolapse itself and is usually performed on older people.

What specialist treats it?

The specialist in charge of treating rectal prolapse is the expert in Coloproctology.