Rectal prolapse is a condition where the rectum (the last part of the large intestine) slips down and protrudes through the anus. This can occur partially or completely, and it affects people of all ages, though it’s more common in older women and young children.

Symptoms

The main symptoms of rectal prolapse include:

• A reddish mass protruding from the anus, especially after bowel movements
• Difficulty controlling bowel movements (fecal incontinence)
• Constipation or loose stools
• Bleeding or mucus leakage from the rectum
• Feeling of incomplete evacuation after bowel movements
• Anal pain or discomfort

Causes

The exact cause of rectal prolapse is not fully understood, but several factors may contribute:

• Chronic constipation or straining during bowel movements
• Weakening of pelvic floor muscles
• Pregnancy and childbirth
• Neurological conditions (e.g., multiple sclerosis, spinal cord injury)
• Chronic coughing or sneezing
• Long-term diarrhea

Diagnosis

Diagnosis of rectal prolapse typically involves:

• Physical examination, including a digital rectal exam
• Observing the patient while they strain, as if having a bowel movement
• Imaging studies such as defecography or colonoscopy in some cases

Treatment

Treatment options for rectal prolapse include:

• Conservative measures (for mild cases or children):
• Dietary modifications to prevent constipation
• Pelvic floor exercises
• Surgery (for most adult cases):
• Abdominal approach (rectopexy)
• Perineal approach (Delorme’s procedure or Altemeier procedure)

The choice of surgical technique depends on the patient’s age, overall health, and severity of the prolapse.