General Information
DEFINITION--Protrusion of rectal tissues outside the anus. Partial prolapse is
protrusion of the mucosa alone, complete prolapse (procidentia) is protrusion of the
entire thickness of the rectum.
BODY PARTS INVOLVED--Anus and rectum.
SEX OR AGE MOST AFFECTED--Adults, usually over age 60, and children ages 1 to 3.
Rectal prolapse in infants can be a sign of cystic fibrosis.
SIGNS & SYMPTOMS--
- A mucus discharge--sometimes tinged with blood--from the rectum.
- A firm mass of tissue that can be felt at the anus after a bowel movement.
- Pain when having bowel movements.
CAUSES
- Weak pelvic or rectal muscles.
- Weak anal sphincter.
- Unknown, particularly in children.
RISK INCREASES WITH
- Cystic fibrosis (children).
- Aging.
- Previous surgery on the rectum or vagina.
- Prolonged constipation and straining to have bowel movements.
- Multiple sclerosis.
- Stroke or paralysis.
- Neurological disease.
- Pertussis.
- Nutritional disorders.
> Practice perineal strengthening exercises--
lie down with back on mattress; pull in abdomen and squeeze while taking a deep breath;
or repeatedly squeeze and relax your buttocks while sitting in a chair.
- Do not strain when having bowel movements. Avoid constipation and diarrhea.
What To Expect
DIAGNOSTIC MEASURES--
- Your own observation of symptoms.
- Medical history and physical exam by a doctor.
- Examination of the rectal area by anoscope or sigmoidoscope (See Glossary for both).
APPROPRIATE HEALTH CARE
- Treatment varies according to underlying cause. Any causes of straining need to be
corrected.
- In children, prolapse is usually temporary.
- Occasionally minor prolapse can often be reversed by gently pushing the protruding
tissue back into the rectum.
- Strapping the buttocks together firmly between bowel movements often cures the
condition.
- For other patients, the excess tissue can be surgically cut out (excised) or tied off
with special rubber bands causing the tissue to wither in a few days.
- Surgery to strengthen tissues that support the rectum (sometimes).
- For people who are unable to have surgery, a wire or synthetic plastic loop can be
inserted to circle the sphincter to constrict the anus and prevent prolapse.
POSSIBLE COMPLICATIONS
- Ulceration and bleeding in tissue that protrudes permanently.
- Bowel incontinence.
- Recurrence of rectal prolapse.
PROBABLE OUTCOME--Good prognosis with treatment. In children, usually complete
recovery.
How To Treat
GENERAL MEASURES---Use sanitary napkins or absorbent pads to absorb the mucus
discharge.
MEDICATION--Your doctor may prescribe stool softeners to prevent constipation.
ACTIVITY--
- Avoid standing or walking for long periods; this increases abdominal pressure.
- Practice perineal and pelvic-strengthening exercises to help prevent a recurrence.
DIET--Drink at least 8 glasses of water a day and eat a diet high in fiber to
prevent constipation.
Call Your Doctor If
- Rectal tissue remains outside the anus.
- Rectal pain or bleeding occur.
- Fever or chills develop, indicating infection.
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