What is rectal prolapse?
Rectal prolapse is a condition in which the last part of your large bowel (rectum) comes out of your anus. This can happen in any of the following three ways:
- The entire rectum comes out of the anus
- Only a portion of the rectum is pushed through the anus
- The rectum has moved out of its place but does not drop out of the anus
Although rectal prolapse can occur at any stage of life, it is more common in older adults who suffer from chronic constipation. Additionally, women aged 50 years and above are more likely to develop rectal prolapse.
What are the causes of rectal prolapse?
Rectal prolapse can be caused by any of the following reasons:
- Weakening of the pelvic muscles (pelvic muscles support your rectum)
- Chronic constipation
- Injury to the rectum
- Nerve damage
- Cystic fibrosis (a hereditary disease that damages the lungs, gut, and pancreas)
- Chronic obstructive pulmonary disease (COPD)
- Bowel infections
- Poor nutrition
What are the symptoms of rectal prolapse?
Rectal prolapse makes you feel that something is bulging out of the anus. Usually, this happens when you strain while defecating. You may be able to push it in by yourself or it may not go inside even after you try pushing it (complete or full-thickness prolapse).
Other symptoms of rectal prolapse include:
- Fecal incontinence (loss of bowel control): Occurs in 5 to 7 out of every 10 patients of rectal prolapse
- Pain in the anus or rectum
- Bleeding from the rectum: Delay in the treatment causes the inner lining of the rectum to develop ulcers leading to significant bleeding.
How do you treat rectal prolapse without surgery?
The main treatment for complete rectal prolapse and recurrent rectal prolapse is surgery. Initially, if it is not severe, the doctor may try fixing it temporarily by a technique known as “manual reduction of the prolapse.”
When only the inner lining (mucosa) of your rectum comes out of the anus, your doctor will instruct you how you can perform self-reduction of your rectal prolapse at home. For this, you have to apply gentle pressure on the rectum to move it back into the anus. It is normal for your rectum to bleed a little during the procedure.
Along with the reduction technique, treating the cause of your rectal prolapse (e.g. constipation) may help you delay or even avoid the surgery. Ask your doctor about what you can do.
Your doctor will usually advise you to
- Avoid constipation by following a healthy diet and regular exercise.
- Take a stool softener to keep your bowel movements soft.
- Do pelvic floor muscle-strengthening exercises.
Pelvic floor exercises, such as Kegel exercises, strengthen your pelvic muscles. Here’s how you can do them:
- Try tightening your pelvic floor muscles slowly for three seconds.
- You will feel like you are lifting them.
- Then release for three seconds.
- Do this 10 times at a stretch. That’s one set.
You should do one set of Kegel exercises two to three times a day. If you cannot perform a set of 10 on your first day, start with a smaller set as much as you can tolerate and build up gradually over time.
How do you shrink rectal prolapse?
Ideally, you cannot shrink the prolapse. You can just restore your rectum to its normal position by manual reduction or surgery.
In rectal prolapse, the rectum can only be shrunk when its mucosa is swollen due to the buildup of fluid in it. For this, before pushing it inside the anus, you can apply a few granules of sugar on it, and let it rest there for a few minutes. Sugar will absorb the excess water in the rectum and cause it to shrink.