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.
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 the highest risk.
It can be caused by chronic conditions, such as constipation or pelvic floor weakness, the latter of which can be the result of vaginal deliveries, pelvic floor trauma and aging.
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. A colonoscopy is often used to rule out any disease or physical causes of the prolapse, such as a large polyp.
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 with another common complaint–prolapsing hemorrhoids. A colon and rectal surgeon can also offer solutions for this condition.
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.
- 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.
- 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. Your surgeon will work with you to determine which option is best.
After surgery, you may work with a pelvic floor physical therapist to learn how to reduce straining, which can increase the risk of rectal prolapse.
Don’t let any 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. Farkas is a board-certified colorectal and general surgeon with over 20 years of experience. She earned her medical degree at the Loyola University Chicago Stritch School of Medicine. Her General Surgery residency was completed at the University of Illinois Chicago and her Colon and Rectal Surgery fellowship at Cook County Hospital. Dr. Farkas was previously an associate professor of surgery at both Duke University and the University of Pittsburgh Medical Center. As professor of surgery at University of California at Davis and University of Texas Southwestern, she led the National Accreditation program for Rectal Cancer at both sites. She has been invited to give many presentations, including internationally, and is widely published. Dr. Farkas has participated in rectal cancer national trials including assessing the safety of laparoscopic and robotic surgery for rectal cancer. She is a fellow of the American College of Surgeons and the American Society of Colon and Rectal Surgeons.