Rectal Prolapse

Introduction
A rectal prolapse occurs when part or all of the rectum (part of the large intestine just above the back passage) slides out through the anus (back passage). It usually happens because the tissues holding the rectum in place (muscles and ligaments) have weakened so it is no longer supported adequately and when the pressure in the abdomen increases – for example when opening the bowels or coughing – the muscles around the back passage aren’t strong enough to hold it in.

Symptoms and signs
The most obvious symptom is of a lump that can be felt outside the back passage. At first it may only appear after opening the bowels (going to the toilet) but later it may come out when standing or walking or when coughing or sneezing. The lump can usually be pushed back inside but sometimes if it stays outside it can swell and become very painful (strangulated prolapse). If this happens then an emergency visit to the hospital is necessary.

Other symptoms include a slimy clear or brown discharge (mucus) through the back passage, involuntary loss of stool or bleeding. It may be difficult to maintain hygiene because of these problems.

Diagnosis of a rectal prolapse
The diagnosis of a rectal prolapse is usually based on the symptoms that you have and a routine examination of your rectum. To get a more accurate assessment of the size and significance of a rectal prolapse, a special x-ray (called an evacuation proctogram) may be performed.

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