Rectal prolapse occurs when the rectum descends (falls and comes through) the anal opening.
Rectal prolapse occurs most often in children under age 6 and in the elderly.
In children, it can be found with cystic fibrosis, worm infections of the intestine, or long-term diarrhea.
In adults, it is usually found with constipation, or with a muscle or nerve problem in the pelvic or genital area.
The main symptom is a reddish-colored mass that sticks out from the opening of the anus, especially after a bowel movement. This reddish mass is actually the inner lining of the rectum. It may bleed slightly and can be uncomfortable and painful.
Exams and Tests
The health care provider will perform a physical exam, which will include a rectal exam. Tests can determine the cause.
Call your health care provider if a rectal prolapse occurs. In some cases, the prolapse can be treated at home.
The rectum must be pushed back inside manually. A soft, warm, wet cloth is used to apply gentle pressure to the mass to push it back through the anal opening. The person should lie on one side in a knee-chest position before applying pressure. This position allows gravity to help put the rectum back into position.
Immediate surgery is rarely needed. In children, treating the cause usually solves the problem. In adults, the only cure for rectal prolapse is a procedure that repairs the weakened anal sphincter and pelvic muscles.
In children, treating the cause usually cures rectal prolapse. In adults, surgery is usually cures the prolapse.
When rectal prolapse is not treated, constipation and loss of bowel control may develop.
When to Contact a Medical Professional
Call your health care provider promptly if there is a rectal prolapse.
In children, treating the cause usually prevents rectal prolapse from happening again.
Fry RD, Mahmoud N, Maron DJ, Ross HM, Bleir JIS. Colon and rectum. In: Townsend CM Jr., Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 52.
Lembo AJ, Ullman SP. Constipation. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisinger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 18.
Verma M, Rafferty J, Buie WD. Practice parameters for the management of rectal prolapse. Dis Colon Rectum. 2011;54:1339-46. PMID: 21979176 www.ncbi.nlm.nih.gov/pubmed/21979176.
Update Date 7/30/2014
Updated by: Jon A. Daller, MD, PhD, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.