Rectal prolapse
Definition
Rectal prolapse occurs when the tissue that lines the rectum falls down into or sticks through the anal opening.
Causes
Rectal prolapse occurs most often in children under age 6 and in the elderly. It is often associated with the following conditions:
- Constipation
- Cystic fibrosis
- Malnutrition and malabsorption (celiac disease is an example)
- Pinworms (enterobiasis)
- Prior injury to the anus or pelvic area
- Whipworm infection (trichuriasis)
Symptoms
The main symptom is a reddish-colored mass that sticks out from the opening of the anus, especially following a bowel movement. The lining of the rectal tissue may be visible and may bleed slightly.
Exams and Tests
The health care provider will perform a physical exam, which may include a rectal exam. Tests will be done to determine the underlying cause.
Treatment
Call your health care provider if a rectal prolapse occurs. In some cases, the prolapse can be treated at home.
The rectal mucosa must be returned to the rectum manually. A soft, warm, wet cloth is used to apply gentle pressure to the mass to push it back through the anal opening. The affected person should be in a knee-chest position before applying pressure to allow gravity to help return the prolapse.
Immediate surgery for repair is seldom needed. The underlying condition must be treated.
Outlook (Prognosis)
Treating the underlying condition usually cures the problem. In otherwise healthy elderly patients who have repeated rectal prolapse, surgery can repair physical problems that make prolapse more likely to occur.
Possible Complications
- Constipation
- Other complications of the condition that caused the prolapse
When to Contact a Medical Professional
Call your health care provider promptly if there is a rectal prolapse.
Prevention
Treating the underlying condition usually prevents further rectal prolapse.
References
Lembo AJ, Ullman SP. Constipation. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisinger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saudners Elsevier;2010:chap 18.
Fry RD, Mahmoud N, Maron DJ, Ross HM, Rombeau J. Colon and rectum. In: Townsend CM Jr., Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 50.
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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