What is rectal prolapse?
Rectal prolapse is a condition where the end part of your rectum (the large bowel) slides out of place and may come out from your anus.
There are three types of rectal prolapse:
- Partial rectal prolapse: This is when only part of the rectum sticks out of your anus. It may happen when you struggle to pass stool. This type of prolapse is more common in children under two years old.
- Complete rectal prolapse: Here the whole rectum comes out of the anus when you experience bowel movements and when you walk or stand. Sometimes the relapsed rectum may remain outside your body all the time.
- Internal rectal prolapse: In this type of prolapse, your rectum moves out of its place but does not come out of the anus.
Symptoms of rectal prolapse
With rectal prolapse, the signs and symptoms may depend on the severity of your condition. 25% to 50% of the people that get this condition report experiencing constipation.
Other symptoms of rectal prolapse include:
- The feeling of a bulge outside your anus
- Pain in your anus or rectum
- Blood and mucus in stool
- Difficulty when passing stool
- Bowel (Faecal) incontinence
- Belly discomfort
- Bleeding from the anus
Sometimes after taking a poop you might feel like you are sitting on a ball. The rectum may return inside on its own during your first days. Later when you feel it outside you may be able to push it back in yourself.
Causes of rectal prolapse
Many different conditions and experience can cause rectal prolapse. These include:
- Chronic (long-term) constipation
- Chronic diarrhea
- Old age: As you get older, the muscles and ligaments around your rectal area get weaker.
- Injury to your anal or hip region
- Damaged nerves: Damage to the nerves that control tightening and loosening could cause rectal prolapse.
- Infections and other conditions
When to see your doctor for rectal prolapse symptoms
You should see your doctor if you start experiencing signs or symptoms of a complication or worsening of your condition.
Call your doctor if you notice these symptoms:
Diagnosing rectal prolapse
When you see your doctor, they will do a rectal exam and complete some tests to make a diagnosis. These tests include:
- Colonoscopy: In this procedure, your doctor will insert a viewing tube (colonoscope) through the rectum to look at your large intestine.
- Anal Ultrasound: Here, the doctor will insert a probe into your anus and rectum to take picture of your anal muscles (sphincters). An ultrasound will help your doctor to check the shape and structure of your anal sphincter muscles and the area around it.
- Anal Manometry: Your doctor may take this test to measure the pressure being produced by your anal muscles to determine their strength. This test is done using a device called a manometer.
- Anal Electromyography (EMG): This test is used to record the electrical activity of muscles. Your doctor may use it to look at the coordination between the rectum and anal muscles. It is mostly an outpatient test to see if the anal muscle and nerves are working correctly.
- Proctosigmoidoscopy: Here, an instrument called the sigmoidoscope (a long thin lighted tube with a camera at the end) is used to examine your rectum and the lower part of your large intestine.
- Magnetic Resonance Imaging (MRI): This is an imaging scan your doctor may use to examine all the organs around your pelvic area.
Treatment of rectal prolapse symptoms
After your doctor examines your condition, they will recommend the type of treatment depending on your age, symptoms, your general health, and the state of your condition.
If your rectal prolapse is severe and interferes with your quality of life, your doctor may advise surgery. After examining the extent of your condition your doctor will advise on the type and timing of your surgery. The type of surgery they will recommend will depend on factors like your age, overall health, and how serious your condition is.
Here are two common types of surgery your doctor may suggest:
- Abdominal Surgery: This is an operation done through the belly.
- Perineal Surgery: Here the operation is done through the bottom.
If you are medically fit for surgery, your surgeon may prefer the abdominal approach since it may offer the best chance of long-term treatment of rectal prolapse.
When it comes to children, treating the cause will mostly solve the problem. For example, if the cause is straining because of dry stool, laxatives will treat the condition.
If you leave your rectal prolapse untreated for long there is a chance that you will experience complications like:
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American Society of Colon & Rectal Surgeons: "Rectal Prolapse Expanded Version."
Aurora Health Care: "Anal Sphincter Electromyography."
Better Health Channel: "Rectal Prolapse."
Johns Hopkins Medicine: "Rectal Prolapse."
Loma Linda University Health "Rectal Prolapse."
MedlinePlus: "Rectal Prolapse."
University of Michigan: "Rectal Prolapse."
University of Rochester Medical Centre: "Rectal Prolapse."