Rectal Prolapse

Causes, Symptoms and Diagnosis of Rectal Prolapse

Originally published on: March 17th, 2021. Last modified on September 1st, 2021

What is Rectal Prolapse?

Rectal prolapse is when part of your rectum (back passage), or the lining of your rectum, protrudes through your anus. The rectum is the last 20 cm or so of the large bowel and is the temporary storage area for bowel motions.

Types of rectal prolapse

直肠脱垂主要有三种类型。

  • Full-thickness rectal prolapseis when part of the wall of your rectum protrudes through your anus.
  • Mucosal prolapseis when the lining of your rectum protrudes through your anus.
  • Internal intussusception rectal prolapseis when your rectum folds in on itself but doesn’t protrude through your anus.

Rectal prolapse mainly affects women – it is most common in women aged over 50, however, it can happen at any age. It can also affect men and young children under three.

Symptoms of rectal prolapse

你可能会在排便时第一次注意到这种突起,但它也可能发生在你咳嗽或打喷嚏、举起或甚至在你做日常活动,如走路或站起来时。

直肠脱垂的症状与痔疮相似。The most obvious being a lump or swelling coming out of your anus, but you may also experience:

  • 排便时疼痛。
  • Mucus or blood discharge from the protruding tissue. Faecal incontinence.
  • Constipation.
  • Awareness of something protruding upon wiping

Initially you may only have a protrusion when you have a bowel movement which retracts or reduces spontaneously afterwards. However, as the condition develops it may also happen when you cough or stand up. Eventually, the protruding rectum may need to be manually replaced by a finger or it may continually protrude.

If you have internal intussusception rectal prolapse, there may be no lump or swelling coming through your anus. However, you may feel as though something is still in your rectum after you empty your bowels.

Causes of rectal prolapse

It’s not fully understood why rectal prolapse develops. It’s often associated with weakened pelvic floor muscles which are a group of muscles that form a supporting sling between your pubic bone and the base of your spine, and certain conditions that put extra pressure on your abdomen, such as:

  • Pregnancy
  • Menopausal changes
  • Weakened pelvic floor muscles
  • Constipation and/or straining when you have a bowel movement
  • Diarrhoea

Conditions that cause you to cough a lot, such as cystic fibrosis, chronic obstructive pulmonary disease (COPD) or whooping cough, asthma cough or smokers cough. Rectal prolapse is also occasionally related to neurological conditions, including: multiple sclerosis (MS), lumbar disc disease, an injury to your lower back or pelvis, spinal tumours.

In older women, rectal prolapse can occur at the same time as a prolapsed womb or bladder. This is thought to be due to a general weakness in your pelvic floor muscles, which may be related to previous pregnancy and childbirth. For more information on the pelvic floor muscles please read our Pelvic Floor Muscle Exercises fact sheet, available on our website and from our office.

Diagnosis of rectal prolapse

你的全科医生会询问你的症状,并可能通过将带着手套的手指插入直肠来检查你。你的全科医生可能能够诊断直肠脱垂后,他的检查。然后他们可能会考虑将你转介给结肠直肠外科医生,他们专门研究影响肠道的情况进行进一步的检查。

These tests may include:

  • Evacuation proctography-这是一种x光或扫描,显示你的直肠和肛管,当你在排便。
  • Sigmoidoscopy – this uses a thin tube with a light and camera at the end to allow a doctor to look at the inside of your rectum and lower part of your bowel.
  • Colonoscopy– this uses a narrow, flexible, tube-like telescopic camera called a colonoscope to allow a doctor to look higher inside your large bowel.
  • Endoanal ultrasound– this uses a thin ultrasound probe to look at the muscles used for bowel control.
  • Transit study-对有便秘史的患者,检查其肠道运动是否正常或缓慢。
  • Ano-rectal physiology– These tests are designed to measure the strength of the muscles around your anus and rectum and the sensation inside your anus and rectum.

You may also need to have other tests to rule out any underlying conditions that may be causing your rectum to prolapse.

Further Information

You may wish to seek advice from your local continence clinic. The continence clinics are run by the NHS and you don’t always need to be referred to a clinic by your GP, as some clinics will allow you to book an appointment yourself.
You can find out more about generalProlapse Treatments and Surgeryhere.
You may find ourFind a Healthcare Professionaltool useful in locating your nearest service.
THE INFORMATION ON THIS PAGE IS A GUIDE ONLY. IT IS IMPORTANT THAT YOU SPEAK TO YOUR GP OR A QUALIFIED HEALTH PROFESSIONAL BEFORE UNDERTAKING ANY TREATMENTS.

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