...

What is Rectal Prolapse?

When the rectum, the portion of the digestive system above the anus (where stool, or poo, exits the body), slides below its natural position, it is referred to as rectal prolapse. 

Rectal prolapses can be categorised in the following ways:

  1. Depending on whether the prolapsed rectum is visible externally or not:
  • Internal Rectal Prolapse: Here, the rectum slides down into the anus but does not protrude out of it.
  • External Rectal Prolapse: Here, the rectum slides down and protrudes through the anus.
  1. Depending on the layers of the rectal wall that slide down:
  • Partial Thickness Rectal Prolapse: As the name suggests, only the inner part of the rectal wall, called the mucosal layer, slides down.
  • Full Thickness Rectal Prolapse: Here, the entire rectal wall slides down.

Rectal prolapse in adults usually requires surgery to treat it. A rectal prolapse cannot heal itself. It is recommended that you consult a doctor if you are feeling any discomfort from a suspected rectal prolapse.

What causes rectal prolapse in adults?

Women who have had babies by vaginal delivery are more prone to develop rectal prolapse. Other factors include straining in the long term to open your bowels due to constipation or diarrhoea. Weakness of pelvic floor muscles and pelvic surgery can increase the risk of developing rectal prolapse.

What are the Symptoms of Rectal Prolapse?

Rectal prolapse symptoms vary based on the type and severity. Commonly reported signs of rectal prolapse include:

  • A protrusion or bulge in the anus (external protrusion appears red and fleshy; in some cases, the protrusion may appear only during bowel movements)
  • Discharge of mucus or blood from the anus
  • Faecal incontinence, i.e. the inability to control bowel movements
  • Difficulty in passing stool
  • Discomfort, itching or pain in the anus

Rectal Prolapse vs Haemorrhoids

Many symptoms of rectal prolapse mimic the symptoms of haemorrhoids or piles. These include:

  • Protruding tissue from the anus
  • Anal discomfort, itching, or pain
  • Blood in the stool
  • Difficult bowel movements

The consequences and treatments for rectal prolapse vs haemorrhoids are vastly different. A rectal prolapse cannot heal itself, and will only get worse with time. Left untreated, it can lead to complications such as faecal incontinence. The only treatment option for rectal prolapse in adults is surgery.

It can be tricky for you to distinguish between a haemorrhoid and a rectal prolapse at home. Experts have the ability to identify these subtle differences. Therefore, it is very important that you consult a doctor for an accurate diagnosis and a suitable treatment plan.

When Should You Seek Medical Help?

In the initial stages, you may be able to manage a rectal prolapse at home. While the rectum will not go back to its original position permanently, you may be able to push the protrusion back into the anus manually with your fingers. However, it cannot heal by itself and will worsen with time.

Due to the stigma and embarrassment surrounding conditions related to the bowel, many patients find themselves uncomfortable seeking treatment for rectal prolapse. If you experience the rectal prolapse symptoms listed above and suspect a rectal prolapse, it is recommended that you consult a doctor soon. 

Diagnosing yourself with less critical conditions like haemorrhoids and leaving a rectal prolapse untreated can lead to several serious complications. These include faecal incontinence (the inability to control bowel movements) and strangulation (the death of prolapsed rectal tissue due to its blood supply being cut off).

What Causes Rectal Prolapse?

A rectal prolapse occurs as a result of weakened muscles holding the rectum in place inside the body. These may be the pelvic floor muscles or the anal sphincter muscles. 

There are several potential causes for the weakening of these muscles, including:

  • Natural ageing process
  • Vaginal childbirth
  • Persistent constipation or diarrhoea over a long period of time
  • Lifting heavy weights or objects
  • Overuse of laxatives
  • Lower back problems
  • Any condition that increases abdominal pressure

Rectal prolapse affects women more often than men. The exact reason for this susceptibility is unknown. Although it may be assumed that this is due to childbirth, there is a significant percentage of women suffering from rectal prolapse who have never given birth.

How is Rectal Prolapse Diagnosed?

Your doctor will listen to your concerns, the symptoms you are experiencing, and your detailed medical history before moving on to the next steps. A physical examination is usually performed to examine the affected area. 

If the protruding tissue appears externally only during bowel movements, the doctor may ask you to mimic a bowel movement to examine the tissue. They may also perform a Digital Rectal Examination (DRE) using a gloved and lubricated finger.

If the doctor suspects a rectal prolapse, they may suggest other tests to confirm the diagnosis. These include:

  • Evacuation Proctogram or Videofecogram or Defecography: This involves the use of x-rays to capture a video of your rectum and adjacent muscles during a bowel movement.
  • Anorectal Manometry: This test is used to evaluate the strength and activity of the anal sphincter muscles.

The doctor may also prescribe other targeted tests if any underlying conditions are suspected.

What are the Treatment Options for Rectal Prolapse?

The goal of rectal prolapse treatment is to surgically return the prolapsed rectum to its normal position. The type of surgery performed depends on factors like the type of rectal prolapse and the general health of the patient. The different rectal prolapse surgery options include:

1. Abdominal Rectopexy

Abdominal Rectopexy is a surgical procedure performed via the abdomen, that returns the rectum to its natural position by stitching it to the pelvis wall. Sometimes, a mesh is used to ensure that it stays in place. This can be performed through an open procedure, which involves a single large abdominal incision, or through a laparoscopic or keyhole procedure, which involves several small abdominal incisions.

2. Pelvic Floor Physiotherapy

Pelvic physiotherapy is also an option for treating rectal prolapse. This non-invasive approach involves exercises and techniques to strengthen the pelvic floor muscles to provide better support for the rectum and surrounding area. Methods for addressing tense pelvic floor muscles typically include hands-on therapy, breathing exercises, mindfulness exercises, biofeedback, and methods for easing tension and elongating the pelvic floor.

3. Surgery

  • Altemeier Procedure: 

Altemeier Procedure is a full-thickness rectal prolapse surgery that involves removing the prolapsed rectum and reattaching the anus and remaining portion of the bowel to form a new “rectum.”

  • Delorme Procedure: 

Delorme procedure is used for mucosal rectal prolapse treatment. The prolapsed mucosal lining is removed, and the rectal wall is strengthened by folding the muscle wall on itself and sewing it together to form a double layer.

The doctor will take you through each rectal prolapse surgery option in detail.

Why Choose the Leicester Bowel Clinic?

Book a consultation with us to get treatment for your condition.

At Leicester Bowel Clinic, we focus on bowel health and conditions, digestive issues, and cancer care. Our clinic offers minimally invasive procedures for bowel problems, ensuring effective results and patient comfort. We aim to provide personalised care for our patients and offer the latest treatments for hernias, bowel conditions and rectal disorders.

Want to book an appointment?

Connect with
us now

Book a consultation
Request a call back

Pricing

Consultations start at

£200

Request a call back by filling out the contact form to the right.

We look forward to assisting you!

request a call back

Our Locations

Leicester Bowel Clinic at Spire Hospital

  • Wednesdays evenings (Mr Runau) from 6:00 pm until 9:00 pm at: Spire Leicester Hospital Gartree Road Leicester LE2 2FF
  • To arrange an appointment directly with the Spire Leicester Hospital, please call the booking line on 0116 2653685

*Free on-site parking is available.

Frequently Asked Questions

01. How serious is a rectal prolapse?

In its initial stages, a rectal prolapse is not a critical condition. However, left untreated, rectal prolapse can lead to complications like faecal incontinence. This is where you lose control of your bowel movements. It can also lead to life-threatening complications like strangulation, where the prolapsed tissue dies due to its blood supply being cut off. It is suggested that you consult a doctor to avoid any complications.

02. Can a rectal prolapse fix itself?

A rectal prolapse does not heal on its own. Its symptoms will usually worsen with time. It is easy to mistake the symptoms of rectal prolapse with other common conditions, like haemorrhoids. It is important to avoid self-diagnosis and seek professional medical care to obtain an accurate diagnosis.

03. How do you fix a rectal prolapse?

Rectal prolapse often requires surgery to restore the prolapsed tissue to its natural position. Depending on the severity of the case, your general health, and other determining factors, a specialist can recommend the best treatment option for you.

04. At what age is rectal prolapse common?

Rectal prolapse commonly affects older adults above the age of 50. The majority of individuals diagnosed with rectal prolapse are women.