Rectal prolapse

Learn more about rectal prolapse

Rectal prolapse

A rectal prolapse occurs when there is loss or weakening of the supporting structures of the rectum. This allows the rectum to descend and infold, much like a telescope may fold inside itself. This infolding (medically called intussusception) may result in difficulties with defecation, called obstructed defecation.

The typical symptoms of obstructed defecation are:

  • An inability to start defecation
  • The need to apply support or pressure on the perineum
  • The need to use a finger to support the back wall of the vagina
  • A sensation of incomplete emptying
  • The need to return to the toilet multiple times
  • Faecal leakage, soiling or incontinence.
The prolapse may be internal, or external. An external prolapse may be subtle, or large, irritated, bleeding and uncomfortable. A prolapse is typically more common in women after childbirth, and with the natural weakening of supporting structures that occurs with age. Investigation of a rectal prolapse often requires a colonoscopy to exclude other causes of defecatory disturbance, anorectal functional studies or an x-ray defecating proctogram (DPG). Treatment may include dietary modification, stool softeners or the use of enemas. It may be beneficial to see a pelvic floor physiotherapy specialist. Surgery may be required, particularly if conservative measures do not improve symptoms.

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