The rectum is the final section of the large intestine before the anus (the opening through which stool passes out of the body). Rectal prolapse is an uncomfortable condition that usually requires surgery to fix. Symptoms of rectal prolapse may include:
Bright red tissue sticking out of the anus (the tissue might be bloody or have mucus on it, and it may move back inside the body on its own or stay outside the anus)An uncomfortable sensation like something is falling out, or like you’re sitting on a ballTrouble beginning a bowel movementFeeling like you can’t completely empty your bowelsFecal incontinence (inability to control your bowel movements; feces may leak out unexpectedly)
Chronic constipation (difficult bowel movements that happen less than three times in a week)Chronic diarrhea (bowel movements are watery or runny, and happen more than three times a day on a regular basis)History of straining during bowel movementsWeak muscles in the pelvic areaBeing of older age (muscles in the area weaken with age)Previous injury in the anal or pelvic areaNerve damage (may be due to pregnancy, difficult vaginal birth, paralysis of the anal sphincter, spinal injury, or back injury)
Defecogram X-rays taken during a bowel movement examine muscle movement.Anorectal manometry A thin tube is used to measure the strength of the sphincter.Colonoscopy A tube with a camera is used to examine the colon.Anal sphincter electromyography (EMG) An electrode measures sphincter muscle activity.MRI This test can help assess organs used during a bowel movement.
Prognosis of Rectal Prolapse
Prognosis tends to be good. If surgery is needed, it has a high success rate and usually cures the prolapse. If none of these strategies help, surgery is usually required — especially if you’re experiencing recurrent episodes. Surgery can keep rectal prolapse from happening again. Two types of surgical procedures are typically used to treat rectal prolapse:
Abdominal repair Surgery to fix rectal prolapse is usually done through the belly. Abdominal surgery for rectal prolapse usually involves making a small cut in the lower abdomen. The surgeon will then pull the rectum upward and attach it to a small bone in the lower back so that it can’t slip out again.Rectal repair In this type of surgery, the surgeon works through the anus rather than making an incision in the abdomen. This surgery is often performed on older patients or those with more medical problems.
The two most common rectal procedures are:
Altemeier procedure In this procedure, the surgeon cuts off or removes a portion of the rectum that extends outside the anus. The remaining rectum is pushed back inside the body and attached to the inside of the anus.Delorme procedure In this procedure, the inner lining of the fallen rectum is removed. The outer lining is then folded and sewn back so that it no longer protrudes.
Prevention of Rectal Prolapse
To prevent rectal prolapse, avoid straining during bowel movements.
Drink plenty of waterEat fruits, vegetables, and other foods that are high in fiberExercise regularlyUse laxatives but only as directed by your healthcare provider because of the potential risks of chronic useConsider bowel training, which involves having a bowel movement at the same time each day
Additional reporting by Abbi Libers and Carlene Bauer.
