Rectal prolapse occurs when the upper portion of the rectum telescopes itself inside out and comes out through the rectal opening. It is seen most often in elderly women, but it can occur in men and women of any age.

What Causes Rectal Prolapse?

Rectal prolapse is associated with chronic straining to pass stool. It is known that the attachments of the rectum to the pelvic bones progressively weaken. When these attachments are weak, straining to pass stool causes the rectum to turn itself inside out. In many cases, the cause is unknown.

What Symptoms Occur with Rectal Prolapse?

The primary symptom is the feeling of tissue coming out of the rectum. Bleeding and mucus drainage frequently accompany rectal prolapse. When the problem first starts, the rectum may turn itself inside out but not come out the rectal opening. During this phase a common symptom is the frequent urge to have a bowel movement when there is no need to pass stool. As the prolapse progresses, the rectum comes out with bowel movements and returns inside by itself. Later the prolapse may occur with any activity and finally just standing up may cause it. It may become necessary to push the rectum back inside.

Constipation commonly occurs with rectal prolapse. The chronic straining associated with constipation may be a predisposing factor, or constipation may occur because the prolapse partially blocks the rectal opening. Continued straining and the prolapse itself may damage the sphincter muscle that controls the passage of stool. If that occurs, accidental bowel leakage, or ABL results. It can be difficult at times to differentiate true accidental bowel leakage from mucus discharge directly from the prolapsed tissue.

How Does Rectal Prolapse Differ from Hemorrhoids?

Hemorrhoids are a cluster of anal cushions (spongy tissue with a lot of blood vessels). A ring of hemorrhoids lies under the skin just outside the rectal opening. A second ring lies under the lining of the rectum just inside the rectal opening. If an inside hemorrhoid enlarges, it may come out the rectal opening with a bowel movement or during exercise. However, only the lining and the blood vessels come out, unlike rectal prolapse where all layers of the rectal wall come out. An examination is necessary to determine the diagnosis.

To learn more about the diagnosis and treatment of rectal prolapse or to schedule a second opinion please contact our Concierge Patient Coordinator at (210) 490-2828 or toll free at (866) 259-3778.