Rectal Prolapse

Definition
Rectal prolapse is a condition that causes part of the large intestine to slip through the anus and turn “inside out.” A prolapsed rectum can cause fetal incontinence and a series of uncomfortable symptoms due to its unique composition. According to the American Society of Colon and Rectal Surgeons, rectal prolapse affects very few people with only 2.5 new cases for every 100,000 people occurring each year.

Causes
Rectal prolapse is generally caused by weak anal sphincter muscles. It may also be caused by weak muscles and ligaments surrounding the rectum. Although the cause of this weakening is not entirely known, physicians speculate various colon and rectal conditions may lead to rectal prolapse. Causes of rectal prolapse may include chronic constipation or diarrhea; old age; pregnancy or childbirth; previous surgery; or paralysis (paraplegia).

Risk Factors
Similar to the causes of this condition, risk factors of rectal prolapse typically include chronic constipation, straining while producing bowel movements, weakened pelvic floor muscles, weakened anal sphincter muscles, pregnancy or childbirth. Additionally, patients over the age of 65 and those with a history of chronic conditions such as benign prostatic hypertrophy or chronic obstructive pulmonary disease (COPD) may be at risk of developing rectal prolapse.

Symptoms
Symptoms of rectal prolapse often vary in severity level depending on the condition’s current state. Nevertheless, symptoms may include the following:

  • Pain or discomfort in the lower abdomen
  • Blood or mucus found in stool
  • Constipation
  • Difficulty passing a bowel movement
  • Fecal incontinence
  • Anal leakage
  • Protrusion of the rectum from the anus

Treatments
To treat rectal prolapse, there are many factors a colon and rectal surgeon must consider before recommending surgery. The age of the patient, the severity of the prolapse, the condition’s symptoms, and the patient’s lifestyle must all be weighed when providing treatment. Most cases of rectal prolapse require a surgical procedure. A colon and rectal surgeon may administer one of the following surgeries to treat rectal prolapse: abdominal rectopexy with possible bowel resection, minimally rectopexy with possible bowel resection, perineal rectosigmoidectomy, or mucosal sleeve resection (Delorme procedure).