Partial prolapse (also called mucosal
prolapse). The lining (mucous membrane) of the rectum slides out of place and
usually sticks out of the anus. This can happen when you strain to have a bowel movement. Partial prolapse is most common in
children younger than 2 years.
Complete prolapse. The entire
wall of the rectum slides out of place and usually sticks out of the anus. At
first, this may occur only during bowel movements. Eventually, it may occur
when you stand or walk. And in some cases, the prolapsed tissue may remain
outside your body all the time.
Internal prolapse (intussusception). One part of the wall of the large
intestine (colon) or rectum may slide into or over another part, like the
folding parts of a toy telescope. The rectum does not stick out of the anus. (See
a picture of
intussusception.) Intussusception is most common in
children and rarely affects adults. In children, the cause is usually not
known. In adults, it is usually related to another intestinal problem, such as
a growth of tissue in the wall of the intestines (such as a
polyp or tumor).
In severe cases of rectal prolapse, a section of the
large intestine drops from its normal position as the tissues that hold it in
place stretch. Typically there is a sharp bend where the rectum begins. With
rectal prolapse, this bend and other curves in the rectum may straighten,
making it difficult to keep stool from leaking out (fecal incontinence).
Rectal prolapse is most common in children
and older adults, especially women.
What causes rectal prolapse?
increase the chance of developing rectal prolapse. Risk factors for children
Cystic fibrosis. A child who has rectal prolapse with no obvious cause may need
to be tested for cystic fibrosis.
Having had surgery on the anus as an infant.
Deformities or physical development
Straining during bowel
Risk factors for adults include:
Straining during bowel movements because of
Tissue damage caused by surgery or
Weakness of pelvic floor muscles that occurs naturally with
What are the symptoms?
The first symptoms of
rectal prolapse may be:
Leakage of stool from the anus (fecal
Leakage of mucus or blood from the anus (wet anus).
Other symptoms of rectal prolapse include:
A feeling of having full bowels and an urgent
need to have a bowel movement.
Passage of many very small
The feeling of not being able to empty the bowels
Anal pain, itching, irritation, and
Bright red tissue that sticks out of the anus.
See a doctor
if you or your child has symptoms of
rectal prolapse. If it is not treated, you may have more problems. For example, the leaking stool could get worse, or the rectum could be damaged.
How is rectal prolapse diagnosed?
Your doctor will
diagnose rectal prolapse by asking you questions about your symptoms and past
medical problems and surgeries. He or she will also do a physical exam, which includes checking the rectum for loose tissue and to find out how strongly the
anal sphincter contracts.
You may need
tests to rule out other conditions. For example, you may need a sigmoidoscopy, a
colonoscopy, or a
barium enema to look for tumors, sores
(ulcers), or abnormally narrow areas in the large intestine. Or a child may need a sweat test to check for
cystic fibrosis if prolapse has occurred more than once or the cause is not clear.
How is it treated?
Prolapse in children tends to
go away on its own. You can help keep the prolapse from coming back. If you can, push the prolapse into place as soon as it occurs. You can also have your child use a
potty-training toilet so that he or she does not strain while having a bowel
Sometimes children need treatment. For example, if the prolapse doesn't go away on its own, an injection of medicine into the rectum may help. If the prolapse was caused by another condition, the child may need treatment for that condition.
Home treatment for adults may help treat the prolapse and may be tried before other types of treatments.
If your doctor says it's okay, you can push the prolapse into place.
Avoid constipation. Drink plenty of water, and eat fruits,
vegetables, and other foods that contain fiber. Changes in diet often are
enough to improve or reverse a prolapse of the lining of the rectum (partial
Don't strain while having a bowel movement. Use a stool softener if you need to.
People who have a complete prolapse
or who have a partial prolapse that doesn't improve with a change in diet will need surgery. Surgery
involves attaching the rectum to the muscles of the pelvic floor or the lower
end of the spine (sacrum). Or surgery might involve removing a section of the
large intestine that is no longer supported by the surrounding tissue. Both
procedures may be done in the same surgery.
The American Society of Colon and Rectal Surgeons is the leading
professional society representing more than 1,000 board-certified colon and
rectal surgeons and other surgeons dedicated to treating people with diseases
and disorders affecting the colon, rectum, and anus.
How this information was developed to help you make better health decisions.