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A prolapse of the rectum (the lower part of the large intestine) occurs when the delicate tissue in your rectum is weakened and slips out into the opening of the anus (the end of the digestive tract.)
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There are three different types of rectal prolapse:
Internal rectal prolapse is more common among children than adults, and happens when the rectum begins to drop, but isn't yet visible in the anal area.
Sometimes, though, only part of the rectum makes it to the anus, and in that case it is considered a partial rectal prolapse. This is also more common among children.
When the whole rectal wall falls out into the anus, this is considered a complete rectal prolapse. In this instance, occasionally another part of the large intestine also moves out of place. At first, this will usually happen during a bowel movement, but may later also happen when a person stands or walks. Sometimes it remains outside of the body all of the time.
Risks for rectal prolapse include strained bowel movements, having experienced pregnancy and childbirth, and damage to the nerves around the anal and rectal muscles. Cystic fibrosis, malnutrition, and developmental issues may contribute to rectal prolapse in children. In adults, problems with chronic constipation and a weakened anal sphincter may also lead to rectal prolapse.
Stool leakage (otherwise known as fecal incontinence), anal itching, and bowel movements accompanied by blood are the main symptoms. If it is a complete rectal prolapse, the actual rectal tissue may be visible outside of the anus. Oftentimes, symptoms of a rectal prolapse are similar to those of hemorrhoids. Some patients may experience a recurring feeling of needing to have a bowel movement when they have a rectal prolapse.
If you think you may have a rectal prolapse, a doctor will thoroughly examine both the anal and rectal areas, and may perform a colonoscopy as well. In children, a sweat test may also be performed to determine if cystic fibrosis is the reason for prolapse.
Depending on the nature of the rectal prolapse, it is sometimes possible for a doctor to simply push the tissue back into place. Stool softeners and suppositories may also be used to address the problem. More commonly, however, surgery is necessary to correct the condition. Surgery may be performed through the abdomen, or perineal area. During surgery the rectum will either be surgically attached to the pelvic floor muscles, or part of it will be removed before the doctor reattaches, reinserts, and repositions the rectum.
The best way to avoid a rectal prolapse is to eat a high-fiber diet, and thus avoid chronic constipation.
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