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Rectal Prolapse: Solutions for an Embarrassing Problem

While rectal prolapse may cause discomfort, it's rarely a medical emergency.

Rectal prolapse can cause symptoms which impact quality of life, including stool leakage and hygiene concerns. It is a sensitive topic, but a colon and rectal surgeon can help.

woman over 50

What causes rectal prolapse?

Rectal prolapse occurs when the rectum loses the normal attachments that keep it fixed inside the body, allowing it to slide out through the anal opening–essentially turning it inside out. While rectal prolapse can affect anyone, women greater than 50 years old are at highest risk.

It can be caused by chronic conditions, such as constipation or pelvic floor weakness, the latter of which is often the result of vaginal deliveries or pelvic floor trauma.

What are the symptoms of rectal prolapse?

Symptoms of rectal prolapse include protruding tissue from the anus, bleeding, anal discomfort, fecal incontinence and mucus discharge.

There are also very valid emotional and quality of life concerns resulting from these symptoms. These include embarrassment, fear of intimacy and constant worry over odor and hygiene.

How is rectal prolapse diagnosed?

A colon and rectal surgeon can diagnose rectal prolapse during a physical exam; however, a radiological study called defecography may also be used. This utilizes X-ray or MRI images to show how the muscles and organs work during a bowel movement.

Sometimes the symptoms of rectal prolapse can be confused for another common complaint–prolapsing hemorrhoids. A colon and rectal surgeon can offer solutions for these as well.

If there are other symptoms, like urine leakage and pain, pelvic prolapse may also need to be addressed by another specialist.

How is rectal prolapse treated?

There are two surgical options.

  1. Rectopexy: A minimally invasive procedure to pull the rectum up into its normal position in the pelvis. It may be done in combination with a colon resection and can be performed robotically or laparoscopically using specially-designed instruments and a camera inserted through a few small incisions in the abdomen.
  2. Altemeier and Delorme: Procedures that remove the portion of the rectum that protrudes from the anus. The doctor performs this surgery via the anus.

In both procedures, stitches, and sometimes mesh, are used to secure the rectum back in place.

A surgeon will work with each individual patient to determine which option is best.

Don’t let your embarrassment stop you from reaching out for help. Colon and rectal surgeons specialize in this very sensitive area and can treat an array of colon, rectum and anal concerns.

Dr. Tahilramani is a board-certified colorectal surgeon. She received her medical degree from Virginia Commonwealth University in Richmond, Va. and completed her general surgery residency at INOVA Fairfax Hospital in Falls Church, Va. Dr. Tahilramani was a research fellow at the University of Texas Medical School at Houston, in Houston, TX. She also completed both an advanced minimally invasive colon and rectal surgery fellowship and a colon and rectal surgery fellowship at the Colon and Rectal Clinic of Orlando in Orlando, Fl.

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