The rectum is the last 20 cm or so of the large bowel. It is the temporary storage area for bowel motions. Rectal prolapse occurs when the rectum turns itself inside out and comes out through the anus. Without treatment, the rectum will eventually need to be pushed back in manually.
Women are six times more likely to suffer rectal prolapse than men. Children of both sexes under the age of three years are also commonly affected by rectal prolapse, although the prolapse tends to resolve by itself without the need for surgery.
Rectal prolapse is graded according to its severity, and are categorised as:
Internal prolapse – the rectum has prolapsed, but not so far as to slip through the anus. This is also known as incomplete prolapse
Mucosal prolapse – the interior lining of the rectum protrudes through the anus
External prolapse – the entire thickness of the rectum protrudes through the anus. This is also known as complete or full-thickness prolapse.
Treatment depends on many individual factors, such as the age of the person, the severity of the prolapse, and whether or not other pelvic abnormalities are present.
Diet and lifestyle changes to treat chronic constipation – for example, more fruit, vegetables and wholegrain foods, increased fluid intake and regular exercise. This option is often all that’s needed to successfully treat rectal prolapse in young children
Securing the structures in place with surgical rubber bands – in cases of mucosal prolapse
Surgery is sometimes used to secure the rectum into place. It can be performed through the person’s abdomen or via their anus. One operation involves tethering the rectum to the central bone of the pelvis (sacrum). Another operation is to remove the prolapsed part of the rectum and to rejoin the bowel to restore near-normal bowel function.
Although surgery through the abdomen may give better long-term results, older people may be advised to undergo surgical correction via the anus, since it is easier to recover from this procedure.