Anus Prolapse

Anus Prolapse
Medically Reviewed by Minesh Khatri, MD on September 02, 2022
Prolapse is when any body part slips or falls down from its normal position. Rectal prolapse is when your rectum -- the last section of your large intestine -- drops down or slides out of your anus . While that may sound scary, it’s typically not considered a medical emergency. However, the longer you have the condition, the worse it can get. Living with rectal prolapse can cause embarrassment and affect your quality of life.
If you feel like something just isn’t right when you go to the bathroom, or try to poop , you shouldn’t ignore it or make light of it. Your doctor can diagnose rectal prolapse and suggest treatment to fix it.
If you feel like you’re sitting on a ball after pooping, or if you notice that you have something sticking out of the opening (your anus) where you poop, you could have rectal prolapse.
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:
Early on, rectal prolapse may look like hemorrhoids slipping out of your anal opening, but these are two different conditions. Hemorrhoids are swollen blood vessels in your anus or lower rectum that may cause itching, pain, and blood on the toilet paper when you wipe after you poop. Your doctor can diagnose whether you have rectal prolapse or hemorrhoids.
A variety of things can cause the condition, including:
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.
Any of these health conditions could put you at higher risk for rectal prolapse:
Your doctor can do a rectal exam. While you may hesitate to do this, your doctor may ask you to sit on a toilet and poop or at least try to go. This is helpful because it allows your doctor to see the prolapse.
You may need some other, more advanced tests to diagnose rectal prolapse, 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:
If your rectal prolapse is very minor and it is caught early, your doctor might have you treat it by taking stool softeners to make it easier to go to the bathroom and by pushing the rectum’s tissue back up the anus by hand. But, typically, you will eventually need to have surgery to fix rectal prolapse.
To prevent rectal prolapse, try not to strain when you poop. Try these tips to ease or prevent constipation that leads to straining:
Avoid heavy lifting, as this could put pressure on your bowel muscles.
Rectal prolapse, if it’s not treated, could lead to these complications:
Foundation of the American Society of Colon and Rectal Surgeons: Rectal Prolapse Expanded Version.
Cleveland Clinic: “Rectal Prolapse.”
Mayo Clinic: “Rectal Prolapse Surgery.”
American Congress of Obstetricians and Gynecologists: “Laparoscopy.”
American Society of Colon and Rectal Surgeons: “Rectal Prolapse.”
Victoria State Government Better Health: “Rectal Prolapse.”
University of Massachusetts Memorial Medical Center: “What Is Rectal Prolapse?”
Cedars-Sinai Hospital: “Rectal Prolapse: What is rectal prolapse?”

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Authored by Dr Laurence Knott , Reviewed by Dr Helen Huins | Last edited 2 Jun 2017 | Meets Patient’s editorial guidelines
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Rectal prolapse causes a lump to stick out of your back passage (anus) and this can become quite painful. Although the lump can pop in and out at first, later on it can stay out all the time, especially when you stand up. This can cause problems with daily activities that involve walking or standing for any length of time.
In children, rectal prolapse can occur in:
Click on the links for more information about the highlighted conditions.
Prolapse of the bladder or womb (uterus) doesn't cause rectal prolapse but is sometimes associated with it.
No-one knows how common rectal prolapse is because people often have it without reporting it to their doctor. However, it is known to happen most frequently in the elderly. Women seem to be more prone to it than men.
It is occasionally seen in children, especially from the ages of 1 to 3 years.
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An intussusception occurs when a section of bowel folds into the next section, a bit like the way a telescope folds up. Sometimes the folded bowel pokes outside the back passage (anus) and looks like a rectal prolapse.
A rectal polyp is a thickening of the lining (mucosa) of the bowel that comes to resemble a finger-like structure growing out of the side wall of the gut. If it pokes outside the anus it can resemble a rectal prolapse.
What we know as a pile is a large vein that usually develops from straining whilst going to the loo. This is yet another condition that can look like a rectal prolapse if it pokes outside the anus.
Difference between rectal prolapse and haemorrhoids
Dr Hassan Mahmud, via SlideShare.net
Studies suggest that there is no difference in success rate whichever surgical procedure is used. Your surgeon will discuss the best option, taking on board your age, general health, previous experience with anaesthetics and how long you have had your prolapse. In general, young fit people are better off having a procedure through the tummy (abdomen). Older people may be more suited to perineal operations which can be done under local anaesthetic. There's more of a chance of the prolapse coming back but less risk to your health if you're a bit frail.
The outlook (prognosis) will depend on your age, on whether you have any untreatable causes for the prolapse and on the state of your general health.
About 1 in 10 children who have a rectal prolapse will continue to have it when they grow up, especially if they are aged over 4 years when they first develop it.
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Murphy PB, Wanis K, Schlachta CM, et al ; Systematic review on recent advances in the surgical management of rectal prolapse. Minerva Chir. 2017 Feb72(1):71-80. doi: 10.23736/S0026-4733.16.07205-9. Epub 2016 Oct 6.
Shin EJ ; Surgical treatment of rectal prolapse. J Korean Soc Coloproctol. 2011 Feb27(1):5-12. doi: 10.3393/jksc.2011.27.1.5. Epub 2011 Feb 28.
Yang SJ, Yoon SG, Lim KY, et al ; Laparoscopic Vaginal Suspension and Rectopexy for Rectal Prolapse. Ann Coloproctol. 2017 Apr33(2):64-69. doi: 10.3393/ac.2017.33.2.64. Epub 2017 Apr 28.
Sarmast MH, Askarpour S, Peyvasteh M, et al ; Rectal prolapse in children: a study of 71 cases. Prz Gastroenterol. 201510(2):105-7. doi: 10.5114/pg.2015.49003. Epub 2015 Feb 10.
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Your rectum is the lower part of your colon, where stool forms. If the rectum drops out of its normal place within the body and pushes out of the anal opening, the condition is called rectal prolapse.
In the early stages, a prolapse may happen only after a bowel movement. The protruding rectum may then slip back through the anal canal on its own. Over time, however, the prolapse may become more severe and could require surgery.
Rectal prolapse is usually caused by a weakening of the muscles that support the rectum.
Symptoms of rectal prolapse include:
Feeling a bulge after coughing, sneezing, or lifting
Having mucous discharge in your stool
Having to push the prolapse back into the anus by hand
Having anal pain, bleeding, or itching
Anyone can develop rectal prolapse, but women are more likely to have the condition than men.
These are some conditions that may increase your risk for developing a rectal prolapse:
Spinal cord problems or previous stroke
Your healthcare provider will be able to diagnose rectal prolapse with a medical history and a physical exam. You may be asked to squat and strain as if you are having a bowel movement. Your healthcare providers may also do other tests to confirm the diagnosis. Tests may include:
Videofecogram. A type of X-ray taken during a bowel movement.
Anorectal manometry. A pressure-measuring tube placed inside the rectum to measure how well the muscles that control bowel movements are working.
Colonoscopy. A flexible tube with a camera placed inside the rectum so the healthcare provider can do a visual exam.
Barium enema. X-ray pictures are taken after a type of contrast solution is placed in the rectum.
Treatment often begins with steps to avoid constipation and straining. If your rectal prolapse is severe enough and interferes with your quality of life, your healthcare provider will probably recommend surgery.
Repair done through the abdomen. A cut is made through the lower belly, and the rectum is attached to the lower part of the backbone to support it and keep it in place.
Repair done through the rectum. During this operation, your surgeon must remove the part of the rectum that has prolapsed and join the two ends.
Repair done by combining these techniques
These are the two main types of complications:
A rectal prolapse that can’t be pushed back into the rectum. This can cause the blood supply to the prolapse to be cut off. This complication is called strangulation. It’s painful and needs emergency treatment.
A rectal prolapse that happens again. This can happen up to 40% of the time. Following your healthcare provider’s advice on lifestyle changes can help prevent recurrence. This includes eating a high-fiber diet and drinking enough water.
Call your healthcare provider if you have any of these symptoms:
If you are recovering from rectal prolapse surgery, make sure to take your pain medicine as directed by your healthcare provider. Finish all antibiotics and don’t take any over-the-counter medicine without talking with your surgeon.
These tips for managing rectal prolapse before or after recovery from surgery may help:
Avoid any activities that increase pressure in your rectal area, like straining to have a bowel movement or heavy lifting, for at least 6 months.
Have any persistent cough treated by your healthcare provider. Your healthcare provider may also urge you to stop smoking.
Eat at least 5 servings of fruits and vegetables every day. A high-fiber diet will help prevent constipation and straining.
Drink 6 to 8 glasses of water every day.
If you are constipated, ask your healthcare provider if you should take a stool softener or a bulk laxative.
Stay active and get regular exercise. If you are overweight, try to get back to a healthy weight.
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