Rectal prolapse

Definition
Rectal prolapse is the abnormal protrusion of the rectal mucosa down to or through the anal opening.

Causes, incidence, and risk factors

When protruding through the anus, prolapse appears as a red mass that may be several inches long. The rectal mucosa is visible and may bleed slightly. Rectal prolapse occurs predominantly in children under age 6, and in the elderly.

Rectal prolapse is often associated with other conditions such as:

     
  • Pinworms (enterobiasis)  
  • Whipworm infection (trichuriasis)  
  • Cystic fibrosis  
  • Malnutrition and malabsorption (Celiac disease is an example)  
  • Constipation  
  • Prior trauma to the anus or pelvic area

Symptoms
The main symptom is a protrusion of a reddish mass from the anal opening, especially following a bowel movement.

Signs and tests
See the individual conditions.

Treatment

Call your health care provider if a rectal prolapse occurs. In some cases, the prolapse can be treated at home.

The rectal mucosa must be returned to the rectum manually. A soft, warm, wet cloth is used to apply gentle pressure to the mass to push it back through the anal opening. The affected person should be in a knee-chest position before applying pressure to allow gravity to help return the prolapse.

Immediate surgery for repair is seldom needed. The underlying condition must be treated.

Expectations (prognosis)

Treating the underlying condition usually cures the problem. In otherwise-healthy elderly patients with recurrent rectal prolapse, surgery can repair anatomic problems that predispose them to prolapse.

Complications

     
  • Constipation  
  • Malnutrition or malabsorption  
  • Other complications of the condition that caused the prolapse

Calling your health care provider
Call your health care provider promptly if there is a rectal prolapse.

Prevention
Treating the underlying condition usually prevents further rectal prolapse.

Johns Hopkins patient information

Last revised: December 6, 2012
by Simon D. Mitin, M.D.

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