Rectal Prolapse

Table of Content

1. Rectal Prolapse: A Common Health Issue That Requires Accurate Diagnosis
2. Types of Rectal Prolapse
3. Symptoms of Rectal Prolapse
4. Causes and risk factors for Rectal Prolapse
5. Treatment of Rectal Prolapse or anal prolapse

Rectal Prolapse: A Common Health Issue That Requires Accurate Diagnosis

Rectal prolapse is a condition that directly affects quality of life and may cause discomfort and embarrassment. It occurs when part of the rectal wall or its mucosal lining protrudes through the anus. The extent of this protrusion varies—some cases are temporary or mild, while others are permanent or more severe.

This condition often appears in young children or older adults, particularly women over the age of 50. It is commonly linked to weakened pelvic muscles or chronic conditions that strain the intestines and digestive system.

There are three main types of rectal prolapse:

Partial mucosal prolapse (involving the lining only)
Complete prolapse (involving the entire rectal wall)
Internal prolapse (where the rectum folds inward without exiting the body)

Distinguishing between these types is key to selecting the right treatment.

Symptoms include a visible bulge from the anus, especially during bowel movements. In some cases, it recurs with coughing or prolonged standing. Patients may lose bowel control and feel unclean. Other symptoms include pain, mucus discharge, itching, bleeding, and a persistent sensation of incomplete bowel evacuation.

Several factors contribute to rectal prolapse, such as chronic constipation or diarrhea, cystic fibrosis, chronic lung disease, pelvic weakness after childbirth, and poor nutrition. Previous surgeries or neurological disorders may worsen the condition.

Treatment depends on severity. Options include laparoscopic rectopexy, abdominal surgery, or perineal procedures, which are often preferred for elderly patients. The goal is to restore normal rectal position and improve bowel control.

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Types of rectal prolapse

1. Partial Prolapse

It is also called mucosal prolapse, which is the prolapse of part of the mucous lining of the rectum outside the anus(mucosal prolapse)

2. Complete prolapse

It is the passage of the entire rectal wall out of the anus.

3. Internal Prolapse

This condition is described as part of the rectal wall sliding over another part (not to the outside). In this case, the patient feels that there is something foreign stuck in the rectum after emptying waste (after defecation).

Symptoms of rectal prolapse

Protrusion of tissues and the appearance of a mass or swelling in the anus. Initially, this swelling appears accompanied by defecation, but the condition progresses to occur when coughing or standing.
In some cases, when suffering from rectal prolapse, the patient becomes unable to control defecation (fecal incontinence), and this leads to a feeling of uncleanliness and soiling clothes.
Pain in the anal area, sometimes mucus discharge, irritation and itching, and bleeding from the rectum may occur.
Feeling unable to completely empty the bowel.
A feeling of discomfort in the lower abdomen. An ulcer can develop in the prolapsed part of the rectum.

Causes and risk factors for rectal prolapse

Straining during defecation due to constipation or chronic diarrhea.
Tissue damage resulting from previous surgeries.
Weakness in the pelvic basal muscles, which occurs naturally with age
Stress to the pelvic muscles due to pregnancy and dystocia.
Chronic prostatic enlargement.
Chronic obstructive pulmonary disease (COPD).
Cystic fibrosis.
Whooping cough (Pertussis cough).
Neurological disorders, nerve damage, and spinal cord tumors
Malnutrition and resulting diseases. (Malnutrition).
Deformities, or development of physical problems.

Treatment of rectal prolapse or anal prolapse

Laparoscopy: A patch is placed through the laparoscope so that the rectum is stabilized by raising it from behind to the coccyx, and laterally to the horizontal ligaments.
Repairing prolapse through abdominal surgery: during which a rectopexy is performed, or part of the intestine is removed, and a rectal fixation is performed.
Perineal surgery: It is performed for high-risk people and the elderly who cannot tolerate general anaesthesia. The prolapsed part of the rectum is removed and then fixed, or the inner lining of the prolapsed rectum is removed.

Rectal Prolapse

Rectal Prolapse: A Common Health Issue That Requires Accurate Diagnosis