Rectal Prolapse

The rectum is the last segment of the colon (large bowel), just above the anus.  It functions as a storage area for stool prior to passing a bowel motion. 

The rectum can turn itself inside-out and come out through this anus.  This is a rectal prolapse.

What are the symptoms of a rectal prolapse?

The main symptom of a rectal prolapse is a lump (the rectum) coming out of the anus.  Most commonly, this occurs while passing a bowel motion.

In the early stages, the size of the prolapse may be small and it may go back inside by itself.  If symptoms progress, the prolapse may need to be pushed back in manually. 

Other symptoms that may be associated with a rectal prolapse include blood and mucus from the anus, difficulties passing a bowel motion and reduced ability to control bowel motions (faecal incontinence). 

Sometimes, rectal prolapse may be associated with prolapse of other pelvic organs, such as the vagina.

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What causes a rectal prolapse?

The exact cause of rectal prolapse is not known.  It is more common with increasing age and in females. 

Other factors that may contribute include chronic constipation (and straining at stool), weak muscles of the pelvic floor and/or anus, weakness of the ligaments that normally hold the rectum within the body and certain nerve conditions. 

There may be a family history of similar conditions. 

Sometimes, conditions within the bowel may cause a rectal prolapse to occur.

Rectal prolapse can occur in children.  In children under 3 years old, rectal prolapse often improves on its own over time, with no treatment required.  In older children, it may be associated with conditions that weaken the body’s tissues.

How is a rectal prolapse diagnosed?

Rectal prolapse is easily diagnosed by inspection of the anus if the prolapse is out at the time of examination. 

A colonoscopy is recommended to make sure there are no conditions within the bowel that is causing the prolapse.  Other tests that may aid in diagnosis include specialized X-rays and assessment of the anal muscles.

Learn about Colonoscopy
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How is a rectal prolapse treated?

The treatment of rectal prolapse should be personalized, based on factors such as age, severity of symptoms and whether there is associated prolapse of other pelvic organs.  Treatment options include diet and lifestyle modifications, exercises and surgery.

It is recommended that rectal prolapse be treated by a specialist colorectal surgeon for optimal outcomes.

Dr Zhu is a specialist colorectal surgeon and has extensive experience in the treatment of rectal prolapse. 

Dr Zhu can assess your symptoms and recommend a personalized treatment plan.