Rectal Prolapse

Everything You Need to Know About Rectal Prolapse

Rectal prolapse is a condition where part of the rectum slips outside the anus, causing discomfort and potentially serious health issues. This article explores the causes, symptoms, and available treatments for rectal prolapse, providing essential information for those affected by this condition.

What is Rectal Prolapse?

Before waste is expelled, it accumulates in the rectum, located near the end of the intestine just before the anus. Normally, when waste reaches the rectum, it triggers an urge to pass stool, with muscles aiding in its expulsion. However, in cases of rectal prolapse, the rectum may protrude into or through the anal canal.

Healthcare professionals refer to any displacement of body parts from their normal position as “prolapse,” often due to weakened or deteriorating muscles. While some muscle weakening is a normal part of aging, excessive use can accelerate this process.

What Causes Rectal Prolapse?

Rectal prolapse can occur due to various factors, including traumatic childbirth experiences or chronic straining over a lifetime. Some individuals may have a genetic predisposition to this condition.

Another common cause is the weakening of the anal sphincter muscle with age. Neurological conditions like spinal cord injuries or issues such as pelvic floor dysfunction, which is associated with urinary incontinence, can also lead to rectal prolapse. Often, multiple factors contribute to the development of this condition.

Symptoms of Rectal Prolapse

The symptoms of rectal prolapse may include visible tissue protruding from the anus, which can be mistaken for hemorrhoids but involves a section of the intestine. Rectal prolapse can be internal or hidden, complicating diagnosis. Notable symptoms include:

Rectal prolapse can occur during bowel movements or physical activities like coughing or sneezing. In its early stages, the rectum may return to normal post-strain, but surgical intervention becomes necessary as the condition progresses.

How is Rectal Prolapse Treated?

While some minor or early-stage rectal prolapses can be managed non-surgically, complete rectal prolapse usually requires surgical treatment. Surgical options vary, but they typically involve securing the rectum to the surrounding tissues or removing a portion of it to prevent further prolapse.

Procedures can be performed through abdominal or transanal approaches. For patients unable to undergo abdominal surgery, transanal procedures, including the use of an anal support device, are alternatives, mainly reserved for older or less healthy patients. Younger, healthier patients are more likely to undergo abdominal surgeries due to their lower risk of recurrence.

How Effective is the Surgery?

The success of rectal prolapse surgery can vary based on the patient’s age, health, and the condition of the supporting tissues. Abdominal surgeries tend to have a lower rate of recurrence compared to perineal (rectal) surgeries and are generally effective at fixing the prolapse.

How is Rectal Prolapse Diagnosed?

Diagnosis may involve the patient being examined while sitting or squatting, especially during straining, to observe the extent of prolapse. Rectal prolapse can be distinguished from hemorrhoids by the presence of circular mucosal folds. Diagnostic tools may include sigmoidoscopy, colonoscopy, or a radiographic examination of the colon using a barium enema. It’s crucial to rule out primary neurological conditions that could be underlying causes.

Potential Complications

Complications from rectal prolapse can be severe, including:

  1. Development of ulcers in the anus or rectum, which may bleed.
  2. A prolapse that doesn’t retract naturally, posing an emergency if the blood supply is cut off, leading to tissue death.
  3. Damage to the muscles and nerves of the anal sphincter, potentially causing incontinence.

How to Prevent Rectal Prolapse

While rectal prolapse is uncommon, high-risk individuals can take preventive measures such as managing constipation, maintaining a healthy weight, avoiding excessive straining during bowel movements, and strengthening pelvic floor muscles.

How Long Does Recovery Last?

The typical hospital stay post-surgery is 2 to 3 days, with full recovery expected within a month. Patients are advised to avoid straining and heavy lifting for at least 6 months to prevent prolapse recurrence.

Seek Specialized Care for Rectal Prolapse

If you’re experiencing symptoms of rectal prolapse, we encourage you to speak with your doctor about a referral to our clinic. As a dedicated department within North York General Hospital, we specialize in effective treatments for rectal prolapse.