Rectal Prolapse
Rectal prolapse is a condition in which a section of the wall of the rectum falls (descends) from its normal position and, in some cases, protrudes from anus. It mainly affects the elderly, and children younger than six. Women can be affected by prolapse after childbirth, with rectal and vaginal prolapse occurring at the same time.
Causes of Rectal Prolapse
A definitive cause of rectal prolapse has not been determined, although a number of factors, including the following, may contribute to its developing:
- Cystic fibrosis in children
- Frequent straining for bowel movements
- Pelvic-floor dysfunction
- Tissue damage caused by childbirth
- Weakness in the area due to aging
Severe constipation sometimes causes rectal prolapse.
Symptoms of Rectal Prolapse
In addition to the rectum's protruding outside the body through the anus, symptoms of rectal prolapse include the following:
- Fecal incontinence
- Pain or itching in the anus
- Full bowels that feel as if they cannot be completely emptied
Bleeding from the anus can also be a symptom of rectal prolapse.
Diagnosis of Rectal Prolapse
Rectal prolapse is diagnosed after symptoms are reviewed, and a complete physical examination is performed. To rule out underlying conditions, additional tests may be administered. They include colonoscopy, barium enema, and, in children, sweat tests to rule out cystic fibrosis.
Treatment of Rectal Prolapse
Nonsurgical treatments for rectal prolapse include the following:
- Pelvic-floor therapies
- Kegel exercises
- Stool softener, so straining during bowel movements is minimized
Avoiding constipation by drinking plenty of water and eating a high-fiber diet are also nonsurgical treatments for rectal prolapse.
For patients who do not respond to the above, surgery, which is performed through the anus or abdomen, may be necessary. In certain cases, it can be performed laparoscopically. Surgery attaches the rectum to the muscles of the pelvic floor, or lower end of the spine. A section of the large intestine that is no longer supported by the surrounding tissue may have to be removed.
Postsurgery, most patients resume normal bowel function, but are still advised to follow high-fiber diets to avoid constipation.