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What to Do If You Experience a Rectal Prolapse
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Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome.
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Goldstein, S. & Maxwell, P. "Rectal Prolapse" Clinics in Colon and Rectal Surgery 2011 24:39-45.
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Robert Burakoff, MD, MPH, is board-certified in gastroentrology. He is the vice chair for ambulatory services for the department of medicine at Weill Cornell Medical College in New York.
Rectal prolapse is a condition in which there is a protusion of the rectum out through the anus. This article will answer some basic questions about the condition.
Although rectal prolapse can affect anyone, it is most common in adults, and women ages 50 and older have six times the risk as men. 1 It occurs in children, usually between infancy and 4 years of age, who have an underlying predisposing condition. 2 There is no such gender disparity in childhood cases.
Rectal prolapse may develop and worsen over time. The predominant symptom is the sensation of a lump pushing through the anus during a bowel movement. 1 In the early stages, the prolapse will subside on its own. As the condition worsens, the prolapse needs to be manually dealt with or will not recede at all. The prolapse may also be triggered by coughing or standing.
If you suspect that you have a rectal prolapse, make an appointment with your healthcare provider. They will determine if your symptoms are caused by a rectal prolapse or a prolapsed internal hemorrhoid .
There are a wide variety of factors that may contribute to the development of a rectal prolapse. 1 Rectal prolapses may result from obesity, poor bowel habits or chronic constipation, but also may be due to abnormalities in the structure and muscles and ligaments of the anus, rectum and pelvic floor. Pregnancy and injury during childbirth are also possible causes.
The primary treatment for rectal prolapse is surgery . There are numerous types of procedures available; your healthcare provider will determine which is right for you. 1 Factors to be considered are your age, your health status, and whether or not constipation is a chronic problem. The goal of surgery is to repair the prolapse with an eye toward preventing a reoccurrence of the problem.
After surgery, associated symptoms should be relieved; most notably, for most people, fecal incontinence is no longer a problem.
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By Barbara Bolen, PhD
Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome.
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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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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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