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Rectal Prolapse

About Rectal Prolapse

Rectal prolapsed involves the movement of a portion of rectum out through the anus. It can involve either full thickness of the rectal wall or just the lining (mucosal prolapsed). This is often confused with hemorrhoids, which are venous structures within the anal canal. If these become enlarged, these structures can also prolapsed out through the anus. Rectal prolapsed is often caused by a weakening of the muscles of the pelvic floor and ligaments that support the rectum and attach it to the bones in the pelvis.

Although anyone can be affected, it tends to affect older individuals, those who have had hysterectomy or multiple childbirths, or those with chronic constipation or neurologic disorders.

Diagnosis

Diagnosis is often confirmed by a simple office visit and examination. There are varying degrees of rectal prolapsed that can be sizable. The diagnosis must investigate presence of other organ prolapsed (such as bladder or uterus) as this has the potential to influence treatment strategy. Often this is done with a radiology evaluation and examining the inside of the rectum with a scope to determine if a cause for the prolapsed is evident.

Treatment

Treatment of rectal prolapse, especially large ones is often surgical. It involves either fixation of the rectum to prevent ongoing prolpase or removal of a segment of rectum that is redundant. Often this also includes placement of a piece of plastic mesh to aid in the fixation. There are many different surgical approaches to treating this problem and only your doctor can decide which is best for you. Recurrence may occur after surgical treatment. Additionally, alteration in bowel function may occur – such as development of constipation or incontinence. The ultimate result is often difficult to predict prior to surgery. Surgery is the only way to cure significant rectal prolpase.

For more information on prolapse, visit the American Society of Colon and Rectal Surgeons website at:
https://www.fascrs.org/patients/disease-condition/rectal-prolapse

 

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