Rectal prolapse occurs when rectum (last few inches of the large intestine) or part of it becomes stretched out and protrudes into other organs or may even extend out of the anus. This problem is more common in women above the age of 50 as compared to men. Children of both the sex under the age of 3 years may be affected by rectal prolapse. It is not an emergency condition but patient always feels uncomfortable. Surgery is recommended to repair the prolapse in case of adults but in the case of children, prolapse tends to resolve by itself without need for surgery.

Types of Rectal Prolapse:

Partial or Mucosal Prolapse: In this, the internal lining of the rectum protrudes or slides out of the anus. It is less than 2 cm. This type is common in children less than the age of 2 years.

Full-thickness Rectal Prolapse or Procidentia: In this part of the wall including three layers protrudes through the anus. It is usually 2 cm to 5 cm. Initially it occurs only during bowel movements but later on, it may occur while walking or standing also. In some cases, prolapsed tissue remains outside the body during all the time.

Internal prolapse or Intussusception or Occult: In this, the rectum doesn’t protrude through anus but folds on itself. It is more common in children and rarely affects adults.

Causes of Rectal Prolapse:

  • Straining during bowel movements
  • Chronic constipation
  • Chronic cough
  • Pregnancy, difficult vaginal delivery, multiple vaginal deliveries
  • Weakened pelvic floor muscles
  • Weakening of muscles due to aging effects.
  • In the case of children, the causes may be malnutrition, physical development problem and straining during bowel movements.

    Symptoms of Rectal Prolapse:

  • The most common symptom of rectal prolapse is swelling or lump coming out of the anus. In the early stages, it occurs during bowel movements but later on, it happens while coughing, standing or sneezing also.
  • In case of occult or internal prolapse, there is no swelling coming out of the anal opening but there is always a feeling of incomplete evacuation after each bowel movement.
  • Leakage of stool from the anus. (Fecal Incontinence)
  • Leakage of blood or mucus from the anus.
  • Irritation in anal or pain in anal
  • Bright red tissue that sticks out of the anus.
  • Diagnosis of Rectal Prolapse:

    The diagnosis of rectal prolapse is done using physical examination and tests. The tests may include MRI defecography, ultrasound, special x-rays, and anorectal manometry.

    Treatment for Rectal Prolapse:

  • In case of children it tends to go away on its own but if it still occurs then a doctor may give an injection of medicine in the rectum to repair rectal prolapse. You may also train your child to use the potty training toilet so that the child doesn’t strain while bowel movements.
  • Home Treatments
    1. You can push the prolapse back with fingers by consulting doctor.
      Avoid Constipation: Drink plenty of fluids and fiber-rich diet such as fruits, vegetables to avoid constipation. Change in the diet may solve the problem of partial or mucosal prolapse.
      Use stool softener to smooth bowel movements.
      Do exercises to help strengthen the muscles of the pelvic area.

    In case the problem is not solved using home treatments, surgery will be recommended in those cases. During the surgery, the rectum is attached to the muscle of the pelvic floor. There are two main types of surgeries performed for repairing rectal prolapse. One is Rectopexy or Laparoscopic that is done through the abdomen and other one is Stapled Transanal Resection of the Rectum ( STARR ) surgery. It is a surgical procedure that is performed through the anus, requires no external incisions and leaves no visible scars.

    Dr. Chaitanya Shah is the well-known proctologist at Healing Hands Clinic, Chinchwad and has successfully treated a large number of patients suffering from rectal prolapse under the guidance of Dr. Ashwin Porwal. The hospital has its branches at different locations such as Pune, Baner, Chinchwad, Mumbai, Bengaluru, and Nashik. Doctors and surgeons at all the locations are expert in anorectal disorders such as piles, fistula, fissure, hernia, rectal prolapse, constipation, fecal incontinence and many other.

    Author's Bio: 

    The founder surgeon of Healing Hands Clinic is Dr. Ashwin Porwal. He started a small consulting center in the heart of Pune city, today has its wings spread over the entire city with state-of-the-art treatment facilities in each center. HHC has its centers at Pune, Mumbai, Nashik, Bengaluru and Jaipur cities. All the centers have internationally recognized surgeons and doctors; expert in handling anorectal disorders such as piles, constipation, hernia, fistula, fissure, and others. This clinic is a certified center of excellence for the treatment of various anorectal disorders. Dr. Porwal has been a pioneer in this field and has ushered in novel treatments for anorectal diseases. He has ensured that the most advanced treatment techniques from all over the world are made available to his fellow citizens in India.