Patient education: Rectal prolapse in adults (The Basics)

What is rectal prolapse? — Rectal prolapse in adults is a rare condition that happens when some or all of the tissue that lines the rectum sticks out of the anus. (The rectum is the lower part of the large intestine.) Rectal prolapse is most common in older females but can happen in anyone at any age.

What causes rectal prolapse in adults? — People who have 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 means that 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 means that 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 of 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 check if the tissue comes back out.

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

●MRI – This test creates pictures of the inside of the body.

●Cystocolpoproctography – For this test, 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 test also uses contrast material in the rectum and takes X-rays while you have a bowel movement.

●Manometry – This test measures the pressure inside your rectum. It can show if the 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. Good choices are fruits, vegetables, prune juice, and cereal (table 1). You should eat 25 to 30 grams of fiber every day.

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

Other treatment include:

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

●Enemas – For this treatment, 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 kinds of surgery to fix rectal prolapse. The type of surgery 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: High-fiber diet (The Basics)
Patient education: Fecal incontinence (The Basics)
Patient education: Diarrhea in teens and adults (The Basics)
Patient education: Pelvic floor muscle exercises (The Basics)
Patient education: Low-fiber diet (The Basics)

Patient education: Constipation in adults (The Basics)
Patient education: High-fiber diet (Beyond the Basics)
Patient education: Fecal incontinence (Beyond the Basics)