Fart Prolapse

Fart 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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Cohee MW, et al. Benign anorectal conditions: Evaluation and management. American Family Physician. 2020;101:24.
Rectal prolapse. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/anatomic-problems-lower-gi-tract/rectal-prolapse. Accessed March 26, 2021.
Rectal prolapse. American Society of Colon & Rectal Surgeons. https://fascrs.org/patients/diseases-and-conditions/a-z/rectal-prolapse-expanded-version. Accessed March 22, 2021.
Tsunoda A. Surgical treatment of rectal prolapse in the laparoscopic era; A review of the literature. Journal of the Anus, Rectum and Colon. 2020; doi:10.23922/jarc.2019-035.
Varma MG, et al. Surgical approach to rectal procidentia (rectal prolapse). https://www.uptodate.com/contents/search. Accessed March 26, 2021.
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Rectal prolapse occurs when the rectum becomes stretched out and protrudes from the anus.
Rectal prolapse occurs when part of the large intestine's lowest section (rectum) slips outside the muscular opening at the end of the digestive tract (anus). While rectal prolapse may cause discomfort, it's rarely a medical emergency.
Rectal prolapse can sometimes be treated with stool softeners, suppositories and other medications. But surgery is usually needed to treat rectal prolapse.
If you have rectal prolapse, you may notice a reddish mass that comes out of the anus, often while straining during a bowel movement. The mass may slip back inside the anus, or it may remain visible.
The cause for rectal prolapse is unclear. Though it's a common assumption that rectal prolapse is associated with childbirth, about one-third of women with the condition have never had children.
Certain factors may increase your risk of developing rectal prolapse, including:
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The digestive processes in the gut continuously give rise to gaseous byproducts. These gaseous byproducts continue to build up in the gut till they are expelled forcefully through either belching or flatus. Belching is a forceful expulsion of gas produced in the upper gut through the oral cavity. Flatus is the gas that passes out through the anal canal. This is typically the gas that builds up in the lower gut and has an offensive odor. Flatulence refers to a condition in which gas production in the gut is excessive, leading to uncontrolled passing of flatus.
Even though passing gas is a normal physiological process that occurs in every individual, passing gas in public is usually a source of embarrassment. Under normal circumstances, one is able to sense the presence of flatus in the rectum and is able to hold off passing gas till the setting is appropriate. However, some individuals are unable to do so, leading to awkwardness in social settings. Flatulence may be serious enough in such cases to cause depression and anxiety.
Flatus may either pass out silently or with a loud noise. The sound that accompanies the passage of flatus is mainly caused by the passing of gas through the narrow anal sphincter. A part of the sound may also be due to the passage of gas through the buttocks. The sounds produced by the passage of flatus have been broadly classified into four distinct types: silent or slider type, staccato, open sphincter type, and bark type. The loudness of the sound depends on the volume of flatus released and the force with which the flatus escapes through the anal sphincter.
The following are the main sources of flatus in the gut:
Under normal circumstances, less than 200 mL of gas is present in the gut at all times. The majority of this gas comes from the action of intestinal bacteria that reside in the colon and act on the digested food components that pass through this region. Around 75% of the total volume of flatus is contributed by the action of these intestinal bacteria (also referred to as the gut flora).
The population of these gut bacteria is usually kept in check through various mechanisms. An increase or imbalance in the population of these gut flora (in certain diseases) can lead to increased flatulence. The main gases produced by the bacterial decomposition of food in the gut are methane, hydrogen sulfide, and carbon dioxide. The foul odor of the flatus is mainly due to the presence of hydrogen sulfide in it.
The act of controlling the expulsion of flatus is similar to the act of controlling defecation. Both stools and flatus become perceptible when they fill up the rectum, and trigger an urge to expel them. This urge is caused by the stretching of the walls of the rectum due to the feces or the flatus. The anal opening is guarded by an external anal sphincter and an internal anal sphincter.
The external anal sphincter is under voluntary control. However, the internal anal sphincter is not under voluntary control. The internal anal sphincter relaxes once the pressure in the rectum increases to a certain level. But the flatus and feces cannot pass out as long as a person keeps the external anal sphincter closed. However, one cannot keep the external anal sphincter closed voluntarily for a long period since the act becomes very uncomfortable. Once an appropriate setting is found, relaxing the external anal sphincter allows the feces and flatus to pass out.
Despite the exercise of voluntary control over the external anal sphincter, flatulence may become uncontrollable in some cases. Uncontrolled flatulence may be a symptom of an underlying disease. In some cases, it may be the only symptom. In other cases, the following symptoms may accompany uncontrollable flatulence:
Uncontrollable flatulence is caused mainly due to an excessive production of gas in the gut and incontinence due to weak control over the external anal sphincter.
Excessive production of gas can occur due to a variety of factors. One of the most common causes of excessive flatulence is consumption of certain foods such as beans, apples, lentils, corn, cabbage, broccoli, leeks, asparagus, potato, pasta, onions, whole grains, and artificial sweeteners. These foods are rich in sulfur compounds or indigestible fiber, which contribute to the production of gas in the gut.
Excessive flatulence may also be caused by malabsorption syndromes or conditions that result in impairment of digestive processes and infections in the gut. Examples of such conditions include lactose intolerance, malabsorption of fructose, gluten intolerance, Crohn’s disease, biliary and gallbladder diseases, enteritis, pancreatic insufficiency, sorbitol malabsorption, small intestinal bacterial overgrowth, short bowel syndrome, celiac disease, diverticulitis, pseudomembranous colitis, and food poisoning.
In case of malabsorption or food intolerance, bacterial fermentation of food in the gut increases, leading to increased production of gas. Consumption of carbonated beverages and swallowing air during breathing can also increase the amount of gas in the gut. Conditions that delay the transit of food through the gut also lead to an increase in flatulence. Examples of conditions that cause delayed transit through the intestine include gastroparesis, obstruction of gastric outlet, constipation, diverticulosis, and intestinal obstruction.
Involuntary defecation or expulsion of gas caused by an inability to hold off these events is termed as incontinence. The external anal sphincter is usually under voluntary control, which allows us to hold off expulsion of feces and flatus till we find an appropriate setting. However, damage to the nerves that supply the muscles of the anal sphincters can eliminate this voluntary control, resulting in fecal incontinence and uncontrollable flatulence.
Examples of conditions that can cause incontinence include spinal cord injury, diabetic neuropathy, spina bifida, vaginal delivery, stroke, and degenerative conditions affecting the nervous system. In some cases, incontinence may occur without any accompanying dysfunction of the sphincter. This is termed as functional incontinence. Fecal incontinence is more common in the elderly and wheelchair-bound individuals.
The exact treatment for flatulence depends on the nature of the underlying cause. Taking probiotics, simethicone, activated charcoal, and tricyclic antidepressants may help in various cases of uncontrollable flatulence. However, the benefits of these measures have not been proven conclusively. Avoiding foods that promote excessive gas formation may help in the long term management of uncontrollable flatulence.
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