General Practice 2022

Rectal prolapse: what é, symptoms, causes and treatment

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Rectal prolapse: what é, symptoms, causes and treatment
Rectal prolapse: what é, symptoms, causes and treatment

Rectal prolapse is a condition that happens when the inner part of the rectum, which is the final region of the intestine, comes out through the anus and is visible from the outside of the body. Rectal prolapse can result from weakening of the anal muscle due to aging, straining to evacuate, constipation or infection with the Trichuris trichiura parasite, for example.

Depending on the severity, rectal prolapse can be divided into two main types:

  • Partial rectal prolapse: when only the mucous lining layer of the intestine is exposed. In these cases, it may be more difficult to visualize the prolapse;
  • Total rectal prolapse: when all its layers are exteriorized, leading to a large volume of the rectum outside the body.

It is important that the proctologist be consulted so that an evaluation can be carried out and the most appropriate treatment is indicated, which may involve compression of the buttocks, manual reintroduction by the doctor or surgery, according to the severity of the prolapse.

Symptoms of rectal prolapse

Usually, rectal prolapse can be identified by the exteriorization of the rectum, in which it is possible to observe the presence of a dark red, moist and tube-shaped tissue outside the anus. Other signs and symptoms that may arise in case of rectal prolapse are:

  • Abdominal pain;
  • Sensation of a mass in the anus;
  • Burning, bleeding, discomfort and heaviness in the anus;
  • Difficulty defecating and feeling of incomplete evacuation.

It should be remembered that rectal prolapse should not be confused with hemorrhoids.In the case of rectal prolapse, the final part of the intestine can be seen outside the body through the anus, while hemorrhoids arise when the veins in the intestine dilate and come out. Learn more about how to tell if you have hemorrhoids and what to do.

To confirm the diagnosis of rectal prolapse, the coloproctologist performs a proctological examination, through which the prolapse in the anal orifice is observed. In some cases, tests such as colonoscopy, sigmoidoscopy or contrast radiographs may be ordered to facilitate confirmation and observe the extent of the problem.

Main causes

Rectal prolapse is more common in people over 60 years old due to aging and loss of muscle strength in the region. In children under 3 years of age, rectal prolapse is usually due to weakness of the muscles and ligaments that support the bowel. However, other possible causes of rectal prolapse are:

  • Constipation;
  • Intense straining to evacuate;
  • Weakening of the anus muscle;
  • Intestinal infection by the worm Trichuris trichiura;
  • Intestinal malformations;
  • Excessive weight loss.

In addition, prolapse can also arise whenever there is a change in the anatomy of the region, due to surgery, childbirth, some injury or diseases, such as an enlarged prostate or intestinal malformation. Learn about other causes of rectal prolapse.

Is rectal prolapse normal in children?

Infantile rectal prolapse is relatively common in children up to 3 years of age, because the muscles and ligaments that support the rectum are still forming and are not, therefore, strongly attached to the abdominal wall, and when the child has frequent diarrhea, the rectal wall prolapses and comes out.

In this case, the treatment for rectal prolapse in children only consists of reintroducing the rectum, because as the child grows, the rectum will properly fix itself to the wall.In addition, it can also be associated with infections, nutrient absorption deficit and constant constipation. Learn more about the symptoms and treatment of this type of prolapse.

How the treatment is done

Treatment for rectal prolapse should be guided by the gastroenterologist according to the severity of the situation. Generally, treatment includes compression of the buttocks to try to reintroduce the rectum into the anus or, if necessary, manual reintroduction of the rectum by the proctologist.

In cases where rectal prolapse is caused by constipation, treatment also includes laxative medications, increased intake of fiber-rich foods, and intake of about 2 liters of water a day, to try to reduce the effort to evacuate and try to prevent the problem from happening again.

Surgery for rectal prolapse is also an option, but it is only indicated as a last resort and, in cases of frequent rectal prolapse, and in the surgery, part of the rectum can be removed or fixed to the sacrum bone, so that no more prolapse.

Is rectal prolapse curable?

Rectal prolapse is curable, and its treatment includes regularizing bowel function and reintroducing the rectum into the anus through surgery. In children, spontaneous improvement is common with growth, and it is only advisable to maintain guidance from a pediatrician or proctologist.

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