Rectal Prolapse

Rectal prolapse is when part of the rectum protrudes from the anus and is a relatively rare condition. The American Society of Colon and Rectal Surgeons estimates that it affects less than 3 in every 100,000 people.

If you feel like you’re sitting on a ball after a bowel movement, or if you notice that you have something sticking out of the opening, your anus, you could have what is called rectal prolapse.

Prolapse means that a body part has slipped or fallen down from its normal position. Rectal prolapse is when the rectum -- the bottom part of your large intestine -- drops down towards or outside your anus. While that may sound frightening, it is typically not considered a medical emergency. However, the longer you have the condition, the worse it can get. And living with rectal prolapse can cause embarrassment and impact your quality of life, as well.

There are three types of prolapse:

  • The entire rectum sticks out of your anus
  • Part of the rectal lining pokes out of your anus
  • The rectum has started to drop but is not yet sticking out of your anus

Typically, you’ll first experience rectal prolapse after you have a bowel movement. The first time, or first few times, the rectum may return inside on its own. Later, you may feel like something has fallen out of your body, or you just feel something down there that isn’t normal. In those cases, you may be able to push the rectum back in yourself.

Additional symptoms of rectal prolapse can include:

  • Feeling a bulge outside your anus
  • Seeing a red mass outside your anal opening
  • Pain in the anus or rectum
  • Bleeding from the rectum
  • Leaking blood, fecal matter, or mucus from the anus

There are a variety of things can cause the condition, including:

  • Long-term history of diarrhea or constipation
  • Long-term history of having to strain during bowel movements
  • Old age, which weakens muscles and ligaments in the rectal area
  • Previous injury to the anal or hip area
  • Nerve damage that affects your muscles’ ability to tighten and loosen

More women develop rectal prolapse than men, especially women older than 50. In general, older people who have had a history of constipation or problems with their pelvic floor have a higher chance of having the problem.

We will examine you and likely do a rectal exam. This is helpful because it allows your doctor to actually see the prolapse. A variety of more advanced tests might also be performed, especially if you have other related conditions.

The most common treatment for rectal prolapse is surgery to put the rectum back in place, and there are several types. The kind of surgery your doctor recommends will depend on factors such as your overall health, age, and how serious your condition is. The two most common types of surgery:

  • Through the abdomen: This type of surgery can be done either with a large incision or using laparoscopy -- this process uses small cuts and a camera attached to an instrument so the surgeon can see what needs to be done and if there are any additional issues that need to be fixed.
  • Rectal repair: This approach may be used if you are older or have other medical problems. This type of surgery can involve the inner lining of the rectum or the portion of the rectum extending out of the anus.