Definition

The rectum is the end section of the large intestine. A rectal prolapse is when the rectum stretches and falls through the anus. Early treatment can improve outcomes.

Causes

This problem is caused by weak muscles and ligaments. These structures hold the rectum in place.

Risk Factors

This problem is more common in children who are 1 to 3 years of age. It is also more common in older adults.

Things that may raise the risk in children are:

• Cystic fibrosis
• Prior anal surgery
• Malnutrition
• Straining during bowel movements
• Infections

Things that may raise the risk in adults are:

• Straining during bowel movements
• Pregnancy and the stress of childbirth
• Hemorrhoids

Symptoms

Symptoms may be:

• Problems controlling stool (poop)
• Pain when passing stool
• Loss of urge to pass stool
• Feeling of incomplete emptying
• Constipation
• Bleeding or mucous from the anus
• Anal pain or itching
• Tissue that sticks out of the anus

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. It will focus on the anus and rectum.

Images may be taken. This can be done with:

• Defecography—a series of x-rays of the rectum and anus taken during a bowel movement
• Colonoscopy —a visual exam of the rectum and colon using a flexible tube with a tiny camera

An anorectal manometry may also be done. This can measure the strength of the anal muscles, feeling in the rectum, and the reflexes needed to pass stool.

Treatment

Prolapse in children tends to go away on its own. In adults, gentle pressure to the rectum can sometimes push it back into place.

The goal of treatment is to put the tissue back into place. Options are:

Prevention

To lower the risk of this problem:

• Drink plenty of fluids.
• Eat a healthful diet that is high in fiber.
• Do exercises to strengthen the pelvic floor.
• Do not strain when passing stool.