From the Guidelines
Rectal prolapse symptoms include a reddish mass protruding from the anus, which may occur during bowel movements and initially retract on its own but can eventually remain outside the body, and patients often experience fecal incontinence, constipation, and a feeling of incomplete evacuation, as reported in the study by 1.
Common Symptoms
- Mucus or blood discharge from the rectum is common, along with anal pain, discomfort, or itching, as noted in the guidelines by 1.
- Some individuals may feel pressure in the rectal area or notice staining in their underwear.
- The severity of symptoms typically progresses over time, with the prolapse becoming more frequent and difficult to manually reduce.
Importance of Medical Attention
These symptoms occur because the rectum's supporting structures weaken, allowing the rectal lining or full-thickness rectum to push through the anal opening. If you experience these symptoms, seek medical attention promptly as treatment (usually surgical) is necessary to correct the prolapse and prevent complications like tissue damage, ulceration, or worsening incontinence, as suggested by the study 1.
Diagnostic Considerations
The diagnosis of rectal prolapse is generally based on a patient's full history, symptoms, and clinical examination, as stated in the guidelines by 1. In clinical practice, it is essential to make a differential diagnosis with prolapsed hemorrhoids, which can be distinguished by their radial bulging and prolapse of discrete anal cushions, as opposed to the concentric protrusion seen in rectal prolapse, as noted in the study by 1.
From the Research
Symptoms of Rectal Prolapse
- Rectal prolapse can present with a range of symptoms including pain, incomplete evacuation, bloody and/or mucous rectal discharge, and fecal incontinence or constipation 2
- Common symptoms also include rectal bulge, mucous drainage, bleeding, incontinence, constipation, tenesmus, as well as discomfort, pressure, and pain 3
- Full-thickness rectal prolapse can result in pain and fecal incontinence, greatly impairing the quality of life of those afflicted 4
- Rectal prolapse frequently coexists with other pelvic floor disorders, and patients have symptoms associated with combined rectal and genital prolapse 5
Characteristics of Rectal Prolapse
- Complete external rectal prolapse is characterized by a circumferential, full-thickness protrusion of the rectum through the anus, which may be intermittent or may be incarcerated and poses a risk of strangulation 2
- Rectal prolapse is defined as a protrusion of the rectum beyond the anus, and it commonly occurs at the extremes of age 5
- Full-thickness rectal prolapse, or procidentia, is the passage of the full-thickness wall of the rectum beyond the anal sphincters 4
Diagnosis and Treatment
- The diagnosis of rectal prolapse is made based on physical examination, although several other modalities are used to provide additional information about the patients' condition 4
- Surgical management is aimed at restoring physiology by correcting the prolapse and improving continence and constipation 5
- The optimal surgical repair is not yet defined, though laparoscopic rectopexy with mesh is emerging as a more durable approach 3