Rectal Prolapse - Diagnosis

Authored by Dr Laurence Knott, 02 Jun 2017

Patient is a certified member of
The Information Standard

Reviewed by:
Dr Helen Huins, 02 Jun 2017

A prolapsed intussusception

An intussusception occurs when a section of bowel folds into the next section, a bit like the way a telescope folds up. Sometimes the folded bowel pokes outside the back passage (anus) and looks like a rectal prolapse.

A rectal polyp

A rectal polyp is a thickening of the lining (mucosa) of the bowel that comes to resemble a finger-like structure growing out of the side wall of the gut. If it pokes outside the anus it can resemble a rectal prolapse.

A haemorrhoid

What we know as a pile is a large vein that usually develops from straining whilst going to the loo. This is yet another condition that can look like a rectal prolapse if it pokes outside the anus.

Rectal Prolapse and Haemorrhoid

Difference between rectal prolapse and haemorrhoids

Dr Hassan Mahmud, via SlideShare.net

  • It's usually easy to tell if you have piles (haemorrhoids) rather than a rectal prolapse because a prolapse has concentric rings around the outside, whereas piles don't.
  • You may need a barium enema (an X-ray exam of the lower bowel) to check that you haven't got any other bowel conditions. Instead of, or as well as this, you may be offered a colonoscopy (an examination in which a colonoscope - a thin flexible tube containing fibre-optic channels) is passed through your anus and into the lower part of your bowel (the colon).
  • A proctosigmoidoscopy (an examination using a non-flexible scope) is used to check the rectum and anus for ulcers which sometimes occur with rectal prolapse.
  • Anal physiology tests - these sound complicated but are basically ways of examining how your bowel works. They include X-ray pictures while your bowel is emptying (defecography), a test to check the pressure inside your bowel (manometry) and checks to test how well the muscles and nerves of the area are working. All this information is useful, especially if you are going to have surgical treatment.
  • Other tests may be suggested, depending on what conditions the doctor wants to rule out. For example, a sample of your poo may need checking for infection or your child may need a sweat test to rule out cystic fibrosis.

Further reading and references

  • Murphy PB, Wanis K, Schlachta CM, et al; Systematic review on recent advances in the surgical management of rectal prolapse. Minerva Chir. 2017 Feb72(1):71-80. doi: 10.23736/S0026-4733.16.07205-9. Epub 2016 Oct 6.

  • Shin EJ; Surgical treatment of rectal prolapse. J Korean Soc Coloproctol. 2011 Feb27(1):5-12. doi: 10.3393/jksc.2011.27.1.5. Epub 2011 Feb 28.

  • Yang SJ, Yoon SG, Lim KY, et al; Laparoscopic Vaginal Suspension and Rectopexy for Rectal Prolapse. Ann Coloproctol. 2017 Apr33(2):64-69. doi: 10.3393/ac.2017.33.2.64. Epub 2017 Apr 28.

  • Sarmast MH, Askarpour S, Peyvasteh M, et al; Rectal prolapse in children: a study of 71 cases. Prz Gastroenterol. 201510(2):105-7. doi: 10.5114/pg.2015.49003. Epub 2015 Feb 10.

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