Introduction
The word prolapse is used to describe any condition where an internal body organ or tissue has moved down from where it is normally located. A rectal prolapse occurs when part of the rectum protrudes from the anal opening. Rectal prolapse is more common in women than in men.
There are three classifications of rectal prolapse. These are:
Full-Thickness
This is where there is a visible protrusion of all layers of the rectum from the anal opening.
Mucosal
This is where only a section of the rectum lining protrudes through the anal opening.
Internal
This where the rectal lining has moved down from its normal position however there is no protrusion through the anal opening.
Symptoms
Symptoms exhibited depend on the type of prolapse as described above. Typical symptoms include:
- A lump appearing (or that can be felt) on the anus, particularly after a bowel movement; it may also be felt when standing up and/or walking; it looks like a reddish mass.
- Rectal bleeding.
- Discharge of mucous.
- Faecal incontinence.
Prolapse may only occur when having a bowel movement, but this may develop into the prolapse appearing at other times. In some cases, it may be possible to gently push it back through the anal opening, however it is strongly advised to seek medical assistance as soon as you notice any of these symptoms.
Causes
A number of factors may cause prolapse. These include:
- Ageing – the pelvic floor muscles become weaker with age.
- Trauma / injury – trauma or injury to the anus or the pelvis.
- Nerve damage – this may be connected to pregnancy and childbirth, or to spinal injury or surgical injury.
- Chronic constipation or diarrhoea – where either condition has been present for a period of time.
- Toilet habit – particularly commonly having to strain when having a bowel movement.
Tests & Diagnosis
The primary diagnostic test is a visual examination and a rectal examination. The next stage may be to ask the patient to sit on a special diagnostic toilet seat and mimic a bowel movement so that the specialist can see what is happening.
Other tests may include specialized x-rays, anal manometry (which checks the pressure inside the anus and rectum), anal ultrasound and colonoscopy.
