Rectal Prolapse

Rectal Prolapse

Rectal prolapse is a distressing condition that can significantly impact daily life. Rectal prolapse occurs when the rectum, the last part of the large intestine, slips or protrudes through the anus, essentially turning inside out. This condition can cause discomfort, embarrassment, and symptoms like bowel control issues, bleeding, and pain. Though relatively uncommon, affecting about 1 in 200 people, it significantly impacts daily life for those who experience it. Rectal prolapse is more common in older adults and women who have had multiple pregnancies. Early diagnosis and treatment are important to prevent the condition from worsening and to improve the quality of life. Fortunately, with proper care and treatment, many individuals can relieve their symptoms and regain control of their bowel movements.

What is Rectal Prolapse?

Rectal prolapse is when the rectum loses its normal attachments inside the body and sticks out through the anus. This causes the rectum to turn inside-out, creating a visible lump coming out of the anus. At first, this might only happen during bowel movements or when you’re performing physical activity, but over time, it can become a constant problem that affects your life.

The rectum is usually held in place by muscles and tissues in the pelvic floor. When these supports weaken or wear out, the rectum can’t stay where it should be, leading to prolapse. This weakening can happen for many reasons, like ongoing constipation, pushing too hard during bowel movements, childbirth, spinal cord injuries, or specific brain and nerve disorders.

Symptoms of Rectal Prolapse

The main sign of rectal prolapse is seeing the rectum sticking out of the anus. This can range from a small bump that comes and goes to the whole rectum constantly sticking out. Other common signs include:

• Feeling a lump coming out of the anus, especially after going to the bathroom or being active.
• Trouble controlling bowel movements (accidentally leaking stool).
• Mucus or blood coming from the anus.
• Feeling like you can’t empty your bowels completely.
• Constipation or trouble starting a bowel movement.
• Discomfort or pain in your belly.
• Pain, itching, or irritation around the anus.

It’s important to know that these signs can sometimes be caused by other problems, like hemorrhoids or other organs falling out of place. That’s why seeing a physician for a proper check-up is crucial to determine what’s going on and get the right treatment.

Causes of Rectal Prolapse

The main reason for rectal prolapse is that the muscles and tissues that usually hold the rectum in place get weak or worn out. Several things can lead to this weakening, including:

• Long-term constipation and straining to poop.
• Pregnancy and childbirth, especially multiple vaginal deliveries.
• Getting older naturally weakens muscles and tissues.
• Nerve problems like spinal cord injuries.
• Frequent coughing or sneezing.
• Being born with weak pelvic floor muscles.

While both men and women can get rectal prolapse, it’s about six times more common in older women. In younger people, it’s often linked to nerve or developmental issues that weaken the pelvic floor.

Diagnosing Rectal Prolapse

To diagnose rectal prolapse, physicians will:

• Ask about your symptoms and health history.
• Do a physical exam of your anal area.
• Order tests including:
  • Defecography: X-rays or MRI scans while you pretend to poop.
  • Anorectal manometry: Checks how strong your anal muscles are.
  • Colonoscopy: Looks inside your whole colon with a camera.
  • Barium enema: X-ray with contrast dye to see your rectum and colon.

Non-Surgical Treatments for Mild Rectal Prolapse

For mild cases or people who can’t have surgery, your physician might recommend:

• Treating underlying issues like constipation or diarrhea.
• Changing your diet to include more fiber.
• Drinking plenty of water.
• Using stool softeners if needed.
• Avoiding straining during bowel movements.
• Doing pelvic floor exercises (Kegels) to strengthen muscles.
• Using biofeedback therapy to improve muscle control.
• Wearing supportive devices like pessaries.

These treatments aim to prevent the prolapse from worsening and improve the bowels’ function. They can help manage symptoms and may prevent the need for surgery in some cases.

Surgery for Rectal Prolapse

If other treatments don’t work or your prolapse is severe, your physician might suggest surgery. The goal is to put your rectum back where it belongs and keep it there.
There are two main types of surgery for rectal prolapse:

1. Abdominal approach:
   • Rectopexy: The surgeon attaches your rectum to your lower spine to hold it in place. They might also remove part of your colon if needed.
   • Resection and rectopexy: Along with attaching your rectum, the surgeon removes the prolapsed part.
2. Perineal approach:
   • Perineal rectosigmoidectomy (Altemeier procedure): The surgeon removes the prolapsed part of your rectum and colon, then reattaches the remaining colon to your anus.
   • Mucosal sleeve resection (Delorme procedure): The surgeon removes the inner lining of your prolapsed rectum, then folds and stitches the muscle wall back in place.

Preventing Rectal Prolapse

While it’s not always possible to prevent rectal prolapse, there are ways to lower your risk. Eating a high-fiber diet and drinking plenty of water can help prevent constipation and reduce straining during bowel movements. Doing pelvic floor exercises like Kegels can strengthen the muscles that support your rectum. It’s also important to avoid activities that put pressure on your abdomen, like lifting heavy objects or coughing too much. Treating health issues like nerve problems or long-term diarrhea quickly can also reduce your risk. By taking these steps, you can help keep your pelvic floor healthy and reduce the chances of developing rectal prolapse or make it less severe if it does happen.

Find Relief from Rectal Prolapse

While rectal prolapse can be distressing, it is a treatable condition with several options available. Early diagnosis and treatment lead to better outcomes, allowing many individuals to manage the condition effectively and maintain their overall health and well-being.

At Florida Medical Clinic Orlando Health, we provide compassionate care that addresses your medical needs and overall quality of life. From diagnosis to personalized treatment plans, we’re here to help you regain your freedom and enjoy the moments that matter most. Don’t let rectal prolapse hold you back—contact us today, and let’s work together to restore your comfort and well-being.

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