Rectal Prolapse: A Comprehensive Health Guide

• Written by Leena Khowal

  Reviewed by Ritika Malik

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Experiencing unusual discomfort or a feeling that something isn’t right in your lower digestive tract can be worrying. One condition that many people don’t know about until it happens is Rectal Prolapse. While it may sound alarming, understanding what it is, why it happens, and how it can be treated can make a huge difference. 

In this blog, we’ll break down everything you need to know about rectal prolapse, from its causes and symptoms to prevention and treatment options so that you can take control of your digestive health with confidence.

What Is Rectal Prolapse?

The rectum is the last part of your large intestine, and it leads to your anus. It’s where stool is held before being pushed out of the body. When stool fills the rectum, it prompts the need to use the bathroom. A group of muscles helps expel stool through the anus. However, in rectal prolapse, the rectum slips down and may stick out of the body.

"Prolapse" refers to a condition where a part of the body has shifted out of its normal position. This usually happens when the muscles that support that part are weak. As people age, this can occur naturally, but some things can make it happen faster, like having children, or having long-term constipation or diarrhoea.

What are the Rectal Prolapse Symptoms?

If you feel like you are sitting on a ball after going to the bathroom, or if you see something sticking out from your anus, you might have rectal prolapse.

Usually, the first sign happens after a bowel movement. Initially, the rectum may return to its normal position on its own. However, over time, you may feel like something is falling out or experience a strange sensation in that area. Sometimes, you can push it back into place yourself.

Other rectal prolapse symptoms can include:

• A bump outside the anus.
• A red mass sticking out of the anal opening.
• Pain or discomfort in the anal or rectal area.
• Itching around the anus.
• Trouble with constipation.
• Difficulty controlling bowel movements (faecal incontinence).
• Rectal bleeding.
• Leakage of blood, stool, or mucus from the anus.

What Causes Rectal Prolapse?

The exact causes of rectal prolapse remain uncertain to experts. However, specific structural abnormalities and risk factors may heighten the likelihood of this condition.

Structural Abnormalities  

In adults with rectal prolapse, physicians have identified specific issues in the pelvis or the lower gastrointestinal tract. These abnormalities may contribute to the development of rectal prolapse, or the condition itself may increase these pre-existing issues. Common structural abnormalities associated with rectal prolapse in adults include:  

• An inadequately anchored rectum that can move excessively. 
• Weakened pelvic floor muscles.  
• Compromised anal sphincters. 

In children, healthcare professionals have observed variations in rectal structure. For instance, the rectum may lack its typical curvature, appearing straight and vertical, potentially increasing the risk of prolapse.

Risk Factors  

Certain conditions that elevate intra-abdominal pressure or weaken the pelvic floor muscles may increase the risk of rectal prolapse. Some examples include:  

• Persistent constipation or straining during bowel movements  
• Ongoing diarrhoea.  
• Cystic fibrosis.  
• Disorders affecting the nerves or tissues within the pelvic floor muscles.  
• Intestinal infections caused by particular parasites.  
• Prior pelvic surgeries.  
• Whooping cough. 

How to Fix a Rectal Prolapse?

The rectal prolapse treatment surgery is still debated, and there are many factors to consider, including the patient's age, health, gender, and issues with constipation before the surgery. 

Abdominal Approaches

• Rectopexy: The rectum is moved back into its normal position and secured to prevent it from slipping again.
• Sigmoid Resection with Rectopexy: A part of the sigmoid colon (which is the S-shaped section of the large intestine that leads to the rectum) is removed while reconnecting the remaining colon. This helps relieve constipation and supports long-term prolapse control.
• Laparoscopic Rectopexy:A minimally invasive version of rectopexy. It involves more minor cuts, quicker recovery, and fewer complications while achieving similar results.

Perineal Approaches

These surgeries are done through the anus and are often chosen for older or higher-risk patients. They are less invasive but may carry a higher chance of prolapse returning.

• Perineal Rectosigmoidectomy: The procedure removes the rectum and part of the sigmoid colon, reconnecting the remaining parts. Suitable for severe or recurring prolapse.
• Perineal Rectosigmoidectomy with Levatorplasty: Combines rectosigmoidectomy with a procedure to strengthen pelvic muscles, improving bowel control and reducing recurrence.
• Delorme Procedure: Ideal for partial or shorter prolapses. Excess tissue is removed, and the rectal muscles are tightened for better support.
• Anal Encirclement (Thiersch Procedure): This is a less invasive option for patients who cannot undergo major surgery. The anal opening is tightened to prevent further prolapse, though bowel movements may become slightly more difficult.

Final Words

Rectal Prolapse is a condition that can significantly impact a person's quality of life due to its associated symptoms and complications. Understanding the nature of rectal prolapse —its causes and symptoms — is essential for early detection and effective management. While surgical intervention is often necessary, the choice of procedure depends on factors such as the patient's health, age, and specific circumstances. Both abdominal and perineal surgical options are available, each with its advantages and potential risks. 

Consultation with a healthcare professional is crucial for developing a tailored treatment plan. However, it’s important to remember that surgical treatment, hospital stays, diagnostic tests, and follow-up care can be financially overwhelming. This is where comprehensive health insurance plays a crucial role. A good health insurance plan not only covers surgery and hospitalisation costs but also supports pre- and post-surgery medical expenses, easing the financial burden on patients and their families.

Disclaimer: All plan features, benefits, coverage, and claims underwriting are subject to policy terms and conditions. Kindly refer to the brochure, sales prospectus, and policy documents carefully.