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.
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.
Rectal prolapse is usually caused by a weakening of the muscles that support the rectum.
Symptoms of rectal prolapse include:
Feeling a bulge after coughing, sneezing, or lifting
Having mucous discharge in your stool
Pain and rectal bleeding
Having to push the prolapse back into the anus by hand
Feeling pressure in your rectum
Having anal pain, bleeding, or itching
Anyone can develop rectal prolapse, but women are more likely to have the condition than men.
These are some conditions that may increase your risk for developing a rectal prolapse:
A long history of constipation
Straining to have bowel movements
Spinal cord problems or previous stroke
Aging or dementia
Your healthcare provider 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 healthcare 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.
Colonoscopy. A flexible tube with a camera placed inside the rectum so the healthcare provider can do a visual exam.
Barium enema. X-ray pictures are taken after a type of contrast solution is placed in the rectum.
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 healthcare 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
These are the two main types of complications:
A rectal prolapse that can’t be pushed 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 needs emergency treatment.
A rectal prolapse that happens again. This can happen up to 40% of the time. Following your healthcare provider’s advice on lifestyle changes can help prevent recurrence. This includes eating a high-fiber diet and drinking enough water.
When to call the healthcare provider
Call your healthcare provider if you have any of these symptoms:
Managing rectal prolapse
If you are recovering from rectal prolapse surgery, make sure to take your pain medicine as directed by your healthcare 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, like straining to have a bowel movement or heavy lifting, for at least 6 months.
Have any persistent cough treated by your healthcare provider. Your healthcare provider may also urge you to stop smoking.
Eat at least 5 servings of fruits and vegetables every day. A high-fiber diet will help prevent constipation and straining.
Drink 6 to 8 glasses of water every day.
If you are constipated, ask your healthcare provider 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.