Rectal Prolapse - Symptoms and causes

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

What are the symptoms of rectal prolapse?

A lump

  • The first thing you will notice is a lump sticking out of your back passage (anus). In the early stages this will only appear after you've had a poo or strained to pass a motion. It tends to disappear when you stand up.
  • Later on, you may notice the lump in other circumstances that involve straining, like coughing or sneezing.
  • Eventually, the lump may be noticeable most of the time and interfere with day-to-day activities such as walking.
  • You may have to push the lump back with your hand.
  • A doctor examining the prolapse will see a lump sticking out which has concentric rings around it. An ulcer on the prolapse may also be seen.
Rectal Prolapse

Full rectal vs mucosal prolapse

Dr Hassan Mahmud, via SlideShare.net

Other symptoms

  • You may notice pain, constipation and bleeding from the last part of your bowel (the rectum).
  • The muscles around the anus (anal sphincter) may become weak, allowing a little bit of poo to escape (faecal incontinence). This can also happen with slime (mucus) produced by the bowel wall.

Who gets rectal prolapse?

No-one knows how common rectal prolapse is because people often have it without reporting it to their doctor. However, it is known to happen most frequently in the elderly. Women seem to be more prone to it than men.

It is occasionally seen in children, especially from the ages of 1 to 3 years.

What causes rectal prolapse?

  • Anything that increases the pressure inside your tummy (abdomen) can make you more likely to develop a rectal prolapse. This can include:
    • Constipation.
    • Diarrhoea.
    • Straining to pass urine due to a swollen prostate gland.
    • Pregnancy.
    • Persistent cough.
  • Damage to the back passage (anus) or pelvis from previous surgery.
  • Damage to the muscle on the floor of the pelvis.
  • Infections of the bowel with certain types of microbes called parasites (such as amoebiasis and schistosomiasis).
  • Diseases of the nervous system such as multiple sclerosis.
  • Damage to the nerves from back surgery, a slipped disc, or an accident injuring the pelvic nerves.
  • Mental health conditions associated with constipation, such as:
    • Depression.
    • Anxiety (as in irritable bowel syndrome).
    • A side-effect of medicines used to treat psychiatric disorders.

In children, rectal prolapse can occur in:

  • Cystic fibrosis.
  • Ehlers-Danlos syndrome.
  • Hirschsprung's disease (a rare condition that can cause poo to become stuck in the bowel).
  • Malnutrition (not having enough food, not eating the right food, or not being able to absorb the nourishment from food).
  • Rectal polyps.

Click on the links for more information about the highlighted conditions.

Prolapse of the bladder or womb (uterus) doesn't cause rectal prolapse but is sometimes associated with it.

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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