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Rectal Prolapse

Home Rectal Prolapse

What is Rectal Prolapse?

The rectum is the last 20 cm or so of the large bowel. It is the temporary storage area for bowel motions. Rectal prolapse occurs when the rectum turns itself inside out and comes out through the anus. Without treatment, the rectum will eventually need to be pushed back in manually.

Women are six times more likely to suffer rectal prolapse than men. Children of both sexes under the age of three years are also commonly affected by rectal prolapse, although the prolapse tends to resolve by itself without the need for surgery.

colorectal-prolapse-treatment
Rectal prolapse is graded according to its severity, and are categorised as:

Internal prolapse – the rectum has prolapsed, but not so far as to slip through the anus. This is also known as incomplete prolapse
Mucosal prolapse – the interior lining of the rectum protrudes through the anus
External prolapse – the entire thickness of the rectum protrudes through the anus. This is also known as complete or full-thickness prolapse.

Causes & Symptoms​

The exact cause of rectal prolapse is unknown, but some of the common symptoms and causes are:
  • Chronic constipation
  • Straining to pass bowel motions
  • Weakening of the muscles associated with ageing, since rectal prolapse is more common in people aged 65 years and over Genetic susceptibility, since it appears that some people with rectal prolapse have a blood relative with the same condition
  • Parasitic infection, such as schistosomiasis – very rare in Australia
  • Any condition that chronically increases pressure within the abdomen, such as benign prostatic hypertrophy, or chronic obstructive pulmonary disease (COPD)
  • Structural problems with the ligaments that tether the rectum to its surrounds
  • Congenital problems of the bowel, such as Hirschsprung’s disease or neuronal intestinal dysplasia
  • Prior trauma to the lower back
  • Disc disease in the lower back.

Treatments of Rectal Prolapse

Treatment depends on many individual factors, such as the age of the person, the severity of the prolapse, and whether or not other pelvic abnormalities are present.

Diet and lifestyle changes to treat chronic constipation – for example, more fruit, vegetables and wholegrain foods, increased fluid intake and regular exercise. This option is often all that’s needed to successfully treat rectal prolapse in young children
Securing the structures in place with surgical rubber bands – in cases of mucosal prolapse.

Surgery is sometimes used to secure the rectum into place. It can be performed through the person’s abdomen or via their anus.

  • One operation involves tethering the rectum to the central bone of the pelvis (sacrum).
  • Another operation is to remove the prolapsed part of the rectum and to rejoin the bowel to restore near-normal bowel function.

Although surgery through the abdomen may give better long-term results, older people may be advised to undergo surgical correction via the anus, since it is easier to recover from this procedure.

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