Rectal Prolapse

Symptoms

The first sign of rectal prolapse is often the unexpected release of mucus, stool, or blood from the anus.

Other symptoms of rectal prolapse include:

• A feeling of having full bowels and an urgent need to have a bowel movement.
• Passage of many very small stools.
• The feeling of not being able to empty the bowels completely.
• An inability to control bowel movements (fecal incontinence) that becomes worse over time.
• Anal pain, itching, irritation, and bleeding.
• Bright red tissue that protrudes from the anus.

You may notice tissue slipping out of the anus during a bowel movement. As the condition becomes worse, tissue may slide out of the anus when you stand and then may remain outside the anus all the time.

Prolapse of only the lining of the rectum (mucosal prolapse) can be confused with hemorrhoids. In mucosal prolapse, rings of red tissue usually protrude out of the anus while you strain during a bowel movement. In hemorrhoids, the tissue that protrudes out of or next to the anus may look like a red or blue lump, and there may be several lumps.

Complications

Rectal prolapse that is not treated can lead to complications.

• Fecal incontinence may become worse. And permanent damage can occur to the circular muscle that controls the anus (anal sphincter).
• The rectum can become damaged from the tissues rubbing together, which can result in a sore (ulcer) that may bleed.
• Normal blood flow to tissue in the rectum may be cut off. This causes the tissue to die (gangrene).
• If a prolapsed rectum swells, it may prevent the passage of stools.
• In rare cases, a loop of the large intestine is pinched off (strangulated), causing blockage of the intestine (bowel obstruction).

Other conditions that can cause symptoms similar to those of rectal prolapse include inflammatory bowel disease, irritable bowel syndrome, polyps, and colon or rectal cancer. Complications after surgery for hemorrhoids or a fistula also can cause these symptoms.

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Author:	Monica Rhodes	Last Updated: July 23, 2009
Medical Review:	Kathleen Romito, MD - Family Medicine C. Dale Mercer, MD, FRCSC, FACS - General Surgery
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