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Rectal Prolapse

Your rectum is the lower part of your colon, where stool forms. If the rectum drops out of its normal place within the body and pushes out of the anal opening, the condition is called rectal prolapse.

Rectal prolapse is usually caused by a weakening of the muscles that support the rectum. In the early stages, a prolapse may happen only after a bowel movement. The protruding rectum may then slip back through the anal canal on its own. Over time, however, the prolapse may become more severe and could require surgery.

Symptoms

Symptoms of rectal prolapse include:

  • Feeling a bulge after coughing, sneezing, or lifting

  • Having mucous discharge in your stool

  • Pain and rectal bleeding

  • Fecal incontinence

  • Having to push the prolapse back into the anus by hand

  • Feeling pressure in your rectum

  • Being constipated

  • Having anal pain, bleeding, or itching

Who's at risk

Anyone can develop rectal prolapse, but women are more likely to have the condition than men.

Rectal prolapsed can have many causes. These are some of the conditions that may increase your risk:

  • A long history of constipation

  • Straining to have bowel movements

  • Laxative abuse

  • Childbirth

  • Spinal cord problems

  • Cystic fibrosis

  • Aging

Diagnosis

Your doctor will be able to diagnose rectal prolapse with a medical history and a physical exam. You may be asked to squat and strain as if you are having a bowel movement. Your health providers may also do other tests to confirm the diagnosis. Tests may include:

  • Videofecogram. A type of X-ray taken during a bowel movement.

  • Anorectal manometry. A pressure-measuring tube placed inside the rectum to measure how well the muscles that control bowel movements are working.

  • Endoscope. A flexible telescope placed inside the rectum so the doctor can do a visual exam.

  • Barium enema. X-ray pictures are taken after a type of contrast solution is placed in the rectum.

Treatment

Treatment often begins with steps to avoid constipation and straining. If your rectal prolapse is severe enough and interferes with your quality of life, your health care provider will probably recommend surgery.

 

Types of surgery include:

  • Repair done through the abdomen. A cut is made through the lower belly, and the rectum is attached to the lower part of the backbone to support it and keep it in place.

  • Repair done through the rectum. During this operation, your surgeon must remove the part of the rectum that has prolapsed and join the two ends.

  • Repair done by combining these techniques

Complications

These are the two main types of complications:

  • A rectal prolapse that can’t be forced back into the rectum. This can cause the blood supply to the prolapse to be cut off. This complication is called strangulation. It’s painful and requires emergency treatment.

  • A rectal prolapse that happens again. This can happen up to 40 percent of the time. Following your doctor’s advice on lifestyle changes can help prevent recurrence. This includes eating a high-fiber diet and drinking enough water.

When to call the doctor

Call your doctor if you have any of these symptoms:.

  • Fever

  • Chills

  • Redness

  • Swelling

  • Bleeding

  • Discharge

  • Constipation

  • Fecal Incontinence

Managing rectal prolapse

If you are recovering from rectal prolapse surgery, make sure to take your pain medicine as directed by your health care provider. Finish all antibiotics and don’t take any over-the-counter medicine without talking with your surgeon.

These tips for managing rectal prolapse before or after recovery from surgery may help:

  • Avoid any activities that increase pressure in your rectal area, such as straining to have a bowel movement or heavy lifting, for at least six months.

  • Have any persistent cough treated by your doctor. Your doctor may also urge you to stop smoking.

  • Eat at least five servings of fruits and vegetables every day. A high-fiber diet will help prevent constipation and straining.

  • Drink six to eight glasses of water every day.

  • If you are constipated, ask your doctor if you should take a stool softener or a bulk laxative.

  • Stay active and get regular exercise. If you are overweight, try to get back to a healthy weight.

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