Patient education: Rectal prolapse in adults (The Basics)

What is rectal prolapse? — 

This is a rare condition that happens when some or all the tissue that lines the rectum sticks out of the anus. (The rectum is the lower part of the large intestine.) It is most common in older females, but can happen in anyone at any age.

What causes rectal prolapse in adults? — 

People who had more than 1 baby by vaginal birth are more likely to get rectal prolapse. Other health conditions that can make rectal prolapse more likely include:

●Long-term bowel problems such as:

•Constipation – This is when your bowel movements are too hard or small, difficult to get out, and happen fewer than 3 times per week.

•Straining during bowel movements

•Diarrhea – This is when your bowel movements are watery or runny and happen more than 3 times a day.

●Problems in the pelvic area, including weak muscles or a history of pelvic surgery

What are the symptoms of rectal prolapse in adults? — 

The main symptom is bright red tissue sticking out of the anus. The tissue might have mucus or blood on it. Rectal prolapse is not usually painful, but can be uncomfortable. The tissue might stay outside the anus or move back inside the body.

Other symptoms include:

●Trouble starting a bowel movement

●Feeling like you have not fully emptied your bowels

●Leaking solid or liquid bowel movements (called "fecal incontinence")

Is there a test for rectal prolapse? — 

Your doctor or nurse should be able to tell if you have it by doing an exam. If the tissue moved back inside your body, your doctor might ask you to squat or sit on the toilet to see if the tissue comes back out.

You might need other tests. These can also show if you have a different problem. The tests include:

●MRI – This is an imaging test that creates pictures of the inside of the body.

●"Cystocolpoproctography" – A doctor fills your bladder, vagina, and rectum with a substance called "contrast material" that shows up on X-rays. The X-rays show how these parts of your body are working.

●"Defecography" – This also involves putting contrast material in your rectum and taking X-rays while you have a bowel movement.

●"Manometry" – This measures the pressure inside your rectum. It can show if your muscles that control bowel movements are working correctly.

How is rectal prolapse treated? — 

The treatment depends on how serious your symptoms are and if you have other health problems. Whatever treatment you have, your doctor will likely tell you to:

●Eat foods that have a lot of fiber (table 1). Good choices are fruits, vegetables, prune juice, and cereal. You should try to eat 25 to 30 grams of fiber every day.

●Drink 4 to 8 cups of water or other fluids every day to stay hydrated.

Other treatment include:

●Laxatives – These are medicines to help make bowel movements easier to get out. Some are pills you swallow. Others, called "suppositories", go into your rectum.

●Enemas – A doctor or nurse squirts fluid into your rectum to help empty your bowels.

●Pelvic floor muscle training with "biofeedback" – This involves learning exercises to strengthen and relax your pelvic muscles. These include the muscles that control the flow of urine and bowel movements. Biofeedback uses devices called sensors that measure muscle activity. They can tell you if you are using the muscles the right way.

●Surgery – Doctors use different types of surgery to fix rectal prolapse. The type depends on your age and health. It can be done through the belly (for young, healthy people) or through the anus (for older people or people with health problems).

More on this topic

Patient education: Constipation in adults (The Basics)
Patient education: Constipation in children (The Basics)
Patient education: Diarrhea in teens and adults (The Basics)
Patient education: Diarrhea in children (The Basics)
Patient education: High-fiber diet (The Basics)
Patient education: Fecal incontinence (The Basics)
Patient education: How to use rectal medicines (The Basics)
Patient education: How to give an enema (The Basics)
Patient education: Pelvic floor muscle exercises (The Basics)

Patient education: Constipation in adults (Beyond the Basics)
Patient education: Constipation in infants and children (Beyond the Basics)
Patient education: Acute diarrhea in adults (Beyond the Basics)
Patient education: Acute diarrhea in children (Beyond the Basics)
Patient education: High-fiber diet (Beyond the Basics)
Patient education: Fecal incontinence (Beyond the Basics)
Patient education: Pelvic floor muscle exercises (Beyond the Basics)