Information and Treatment for Rectal Prolapse

What Is a Rectal Prolapse?

Rectal prolapse is a condition in which the rectum (the last part of the large intestine before it exits the anus) becomes detached inside the body, allowing it to turn inside out and protrude from the anus. Rectal prolapse may be uncomfortable and embarrassing, but rarely results in a medical emergency. However, it often significantly diminishes a patient’s quality of life.

What Causes a Rectal Prolapse?

Chronic constipation is a problem for 30 to 67 percent of patients who have a rectal prolapse; an additional 15 percent have diarrhea. While some assume that rectal prolapse is a consequence of multiple vaginal deliveries, as many as 35 percent of patients with rectal prolapse have never borne children.

How Common Is Rectal Prolapse?

Rectal prolapse is relatively uncommon. There are approximately 2.5 cases in 100,000 people. According to the American Society of Colon and Rectal Surgeons, this condition affects mostly adults, and women older than 50 are six times as likely as men to develop rectal prolapse. Most of these women are in their 60s, while the few men who develop prolapse are much younger, averaging 40 years old or less.

How Is Rectal Prolapse Diagnosed?

While a spontaneous prolapse is obvious, it can be confusing as to whether a patient has substantial hemorrhoids or rectal prolapse. Among the diagnostic steps a physician will take to ascertain a rectal prolapse are:

• digital rectal examination
• anal manometry (measurement of sphincter pressure)
• observation of the patient while straining (squatting or on a toilet)
• defecography
• colonoscopy

What Can I Do about Rectal Prolapse?

You may decide to do nothing. However, you should be advised that the longer you go without having the prolapse repaired, the larger it is likely to get. Waiting also increases the chance of permanent problems with fecal incontinence, as the anal sphincter is repeatedly stretched and the chance of nerve damage increases. When the prolapse is very small or the patient is too sick to have surgery, supportive garments can help contain it.

What Treatment Is Available for Rectal Prolapse?

Definitive treatment requires surgery. A surgeon will consider an array of factors before deciding which approach is likely to provide the best outcome in your case.

When Should I Make an Appointment with a Specialist?

If you are having significant symptoms that interfere with your quality of life, consult your physician for a referral to a colorectal surgeon who can recommend a course of treatment. The Women’s Medicine Collaborative has specialists who can help.

Learn more about treatment for pelvic floor disorders at Lifespan