Rectal prolapse is a distressing medical condition where the rectum (the last part of the large intestine) slips out of the anus. This condition can cause discomfort, embarrassment, and difficulty in passing stools. While rectal prolapse is more common in older adults and women, it can affect individuals of all ages.
Understanding the causes, symptoms, and treatment options is crucial for effective management. In this article, we will explore rectal prolapse in detail, including its causes, risk factors, treatment options (both non-surgical and surgical), and preventive measures.
What is Rectal Prolapse?
Rectal prolapse occurs when the rectum loses its normal attachment inside the body and protrudes through the anus. It can be partial or complete, depending on the extent of the prolapse.
Types of Rectal Prolapse
There are three main types of rectal prolapse:
- Partial (Mucosal) Prolapse
- Only the inner lining (mucosa) of the rectum protrudes.
- Common in children and often resolves on its own.
- Complete (Full-Thickness) Prolapse
- The entire rectal wall protrudes outside the anus.
- Requires surgical treatment for permanent correction.
- Internal (Hidden) Prolapse
- The rectum folds in on itself internally, without protruding from the anus.
- Difficult to diagnose and often confused with chronic constipation or pelvic floor dysfunction.
Symptoms of Rectal Prolapse
πΉ A visible bulge of tissue outside the anus
πΉ Difficulty in controlling bowel movements (fecal incontinence)
πΉ Mucus or blood discharge from the anus
πΉ A feeling of incomplete bowel emptying
πΉ Chronic constipation or straining while passing stools
πΉ Pain or discomfort in the anal region
πΉ A sensation of fullness or a lump in the rectum
π‘ Early detection is key! If you notice any symptoms, consult a proctologist or colorectal surgeon immediately.
Causes and Risk Factors of Rectal Prolapse
Rectal prolapse is linked to weak pelvic floor muscles and increased pressure on the rectum.
Common Causes:
β Chronic constipation β Excessive straining weakens rectal support structures.
β Chronic diarrhea β Frequent loose stools can weaken the rectal wall.
β Aging β Weakening of muscles and connective tissues with age.
β Pelvic floor dysfunction β Weak or damaged pelvic floor muscles.
β Multiple pregnancies β Vaginal deliveries stretch and weaken pelvic muscles.
β Neurological conditions β Parkinsonβs disease, spinal cord injuries, and multiple sclerosis can impair nerve function, affecting bowel control.
β Prior surgeries β Previous rectal or anal surgeries can weaken the tissues.
β Genetic predisposition β Some individuals may have weaker connective tissues, making them more prone to prolapse.
Diagnosis of Rectal Prolapse
1. Physical Examination
A doctor may ask the patient to strain (push) during a rectal exam to observe if the prolapse occurs.
2. Colonoscopy or Sigmoidoscopy
This test examines the colon and rectum to rule out other conditions like tumors, polyps, or inflammatory diseases.
3. Defecography (X-ray or MRI of the Pelvic Floor)
This imaging test analyzes rectal function during bowel movements to identify internal prolapse.
4. Anorectal Manometry
Measures anal sphincter strength and nerve function, particularly in patients with fecal incontinence.
Treatment Options for Rectal Prolapse
1. Non-Surgical Treatments (Mild Cases)
π Dietary Modifications
- Increase fiber intake (fruits, vegetables, whole grains) to prevent constipation.
- Drink plenty of water (at least 2 liters per day).
- Avoid excessive straining during bowel movements.
π Pelvic Floor Exercises (Kegels)
- Strengthens the muscles supporting the rectum and anus.
π Medications
- Stool softeners and laxatives help reduce straining.
- Biofeedback therapy improves muscle control in some cases.
π‘ Can non-surgical methods cure rectal prolapse?
In mild cases or children with partial prolapse, lifestyle changes can help resolve the condition. However, moderate to severe prolapse requires surgery.
2. Surgical Solutions for Rectal Prolapse
For severe rectal prolapse, surgical intervention is the best treatment.
A. Abdominal (Open or Laparoscopic) Surgery
πΉ Rectopexy β The rectum is lifted and sutured to the sacrum (pelvic bone) to restore normal positioning.
πΉ Rectopexy with Mesh β A mesh is used for additional support, reducing recurrence.
β Recommended for younger, healthier patients.
β Laparoscopic rectopexy is minimally invasive, leading to faster recovery.
B. Perineal Surgery (Through the Anus)
πΉ Altemeier Procedure (Perineal Proctosigmoidectomy)
- The prolapsed rectum is removed, and the healthy rectum is stitched back.
- Best for elderly patients or those who cannot undergo major surgery.
πΉ Delormeβs Procedure
- Used for mild to moderate rectal prolapse.
- Involves removing the inner rectal lining and tightening the muscles.
β Best for frail patients who cannot tolerate major surgery.
Post-Surgery Recovery and Care
β
Dietary adjustments β Eat fiber-rich foods to prevent constipation.
β
Regular walking β Promotes healing and reduces complications.
β
Avoid heavy lifting β Prevents strain on rectal tissues.
β
Pelvic floor exercises β Helps strengthen anal and rectal muscles.
Preventing Rectal Prolapse
π Prevent constipation β Eat fiber, drink water, and avoid excessive straining.
π Exercise regularly β Strengthens pelvic and core muscles.
π Pelvic floor therapy β Beneficial after childbirth or rectal surgeries.
π Avoid prolonged sitting on the toilet β Reduce strain on rectal tissues.
Rectal prolapse is a progressive condition that can impact daily life and bowel function. While mild cases may improve with lifestyle changes, severe prolapse often requires surgery. Early diagnosis and proper treatment can prevent complications and improve quality of life.
If you experience symptoms of rectal prolapse, consult a specialist immediately. With modern surgical techniques and lifestyle modifications, recovery is smoother than ever!
FAQ
1. Can rectal prolapse go away on its own?
π Mild cases, especially in children, may resolve naturally. However, in adults, rectal prolapse typically worsens over time and requires medical intervention.
2. What happens if rectal prolapse is left untreated?
π Chronic prolapse can cause fecal incontinence, ulcerations, infection, and severe discomfort. Early treatment prevents complications.
3. Is rectal prolapse surgery painful?
π Surgery is performed under anesthesia, so there is no pain during the procedure. Mild post-surgical discomfort is manageable with medications.