A Rectal prolapse is rarely talked about, is embarrassing but it can be effectively treated “As the new owner of a rectal prolapse which would appear at random and stay a few minutes or the whole day, I really worried about what lay ahead. Like caring for a baby, my handbag contained all the paraphernalia to keep me, ‘clean, dry and comfortable’, wherever I found myself
A rectal prolapse occurs when the lowest part of the bowel telescopes on itself and protrudes out through the anus. Rectal prolapse usually occurs as a result of pelvic floor weakness. It may be associated with other forms of vaginal prolapse in women. Childbirth may be a contributing factor to the development of pelvic floor weakness in women. Chronic straining may also be responsible for the development of some cases in men and women. Rarely malnutrition may play a part in the development of rectal prolapse.
Most patients are aware of a lump that comes down out of their bottom. Mostly the prolapse happens when patients have their bowels open but it can occur at other times particularly after walking and towards the end of the day. Sometimes the prolapse goes back (reduces) on its own on other occasions the patient has to push it back themselves. Patients may also describe a discharge of mucus from the bottom and sometimes bleeding as well. As the prolapse gets bigger it tends to stretch the muscle around the anus and patients may also have problems with leakage of stool.
As in the case above for most patients with a rectal prolapse an operation will be recommended. There are two types of operation. In one type the prolapse is fixed from below (perineal approach) and in the other type the prolapse is pulled up from above (abdominal approach). The abdominal procedures can often be carried out laparoscopically (also known as keyhole surgery). Rectopexy or ventral mesh rectopexy are the techniques most frequently used. Generally the operations carried out abdominally give better long term results. The perineal operations tend to be recommended for a prolapse where an abdominal operation could be more risky for an elderly patient as the longer term result may not be quite as good. Visit our website to get more information on this and other bowel conditions including Rectocele and Solitary Rectal Ulcer Syndrome.
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