Rectal prolapse occurs
when part or all of the
wall of the rectum slides out of place, sometimes
sticking out of the anus. See a picture of
There are three types of rectal prolapse.
In severe cases of rectal prolapse, a section of the
large intestine drops from its normal position as the tissues that hold it in
place stretch. Typically there is a sharp bend where the rectum begins. With
rectal prolapse, this bend and other curves in the rectum may straighten,
making it difficult to keep stool from leaking out (fecal incontinence).
Rectal prolapse is most common in children
and older adults, especially women.
increase the chance of developing rectal prolapse. Risk factors for children
Risk factors for adults include:
The first symptoms of
rectal prolapse may be:
Other symptoms of rectal prolapse include:
See a doctor
if you or your child has symptoms of
rectal prolapse. If it is not treated, you may have more problems. For example, the leaking stool could get worse, or the rectum could be damaged.
Your doctor will
diagnose rectal prolapse by asking you questions about your symptoms and past
medical problems and surgeries. He or she will also do a physical exam, which includes checking the rectum for loose tissue and to find out how strongly the
anal sphincter contracts.
You may need
tests to rule out other conditions. For example, you may need a sigmoidoscopy, a
colonoscopy, or a
barium enema to look for tumors, sores
(ulcers), or abnormally narrow areas in the large intestine. Or a child may need a sweat test to check for
cystic fibrosis if prolapse has occurred more than once or the cause is not clear.
Prolapse in children tends to
go away on its own. You can help keep the prolapse from coming back. If you can, push the prolapse into place as soon as it occurs. You can also have your child use a
potty-training toilet so that he or she does not strain while having a bowel
Sometimes children need treatment. For example, if the prolapse doesn't go away on its own, an injection of medicine into the rectum may help. If the prolapse was caused by another condition, the child may need treatment for that condition.
Home treatment for adults may help treat the prolapse and may be tried before other types of treatments.
People who have a complete prolapse
or who have a partial prolapse that doesn't improve with a change in diet will need surgery. Surgery
involves attaching the rectum to the muscles of the pelvic floor or the lower
end of the spine (sacrum). Or surgery might involve removing a section of the
large intestine that is no longer supported by the surrounding tissue. Both
procedures may be done in the same surgery.
Learning about rectal prolapse:
The American Society of Colon and Rectal Surgeons is the leading
professional society representing more than 1,000 board-certified colon and
rectal surgeons and other surgeons dedicated to treating people with diseases
and disorders affecting the colon, rectum, and anus.
Other Works ConsultedDozois EJ, Pemberton JH (2006). Rectal prolapse and
solitary rectal ulcer syndrome section of Hemorrhoids and other anorectal
disorders. In MM Wolfe et al., eds., Therapy of Digestive Disorders, 2nd ed., pp. 954–955. Philadelphia: Saunders
Elsevier.Lembo AJ, Ullman SP (2010). Constipation. In M Feldman et al., eds., Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 9th ed., vol. 1, pp. 259–284. Philadelphia: Saunders.
July 6, 2011
Anne C. Poinier, MD - Internal Medicine & C. Dale Mercer, MD, FRCSC, FACS - General Surgery
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