From the Guidelines
Rectal prolapse can indeed cause bleeding, as indicated by the presence of bleeding as a complication in patients with rectal prolapse, for which urgent surgical treatment is suggested 1. When the rectum protrudes through the anus, the exposed rectal tissue can become irritated, inflamed, and damaged, leading to bleeding. This bleeding typically appears as bright red blood on toilet paper, in the toilet bowl, or on stool. The bleeding occurs because the prolapsed rectal tissue is delicate and can easily develop ulcerations or abrasions from friction against clothing or during bowel movements. Some key points to consider in the management of rectal prolapse include:
- The decision for surgical treatment should be based on the presence of complications such as bleeding, acute bowel obstruction, or failure of non-operative management 1.
- In patients with complicated rectal prolapse and bleeding, urgent surgical treatment is suggested, as indicated by the guidelines 1.
- The choice of surgical approach, whether abdominal or perineal, should be based on the specific patient's characteristics and the surgeon's skills and expertise 1.
- Immediate surgical intervention is reserved for those patients who present with incarcerated rectal prolapse complicated by gangrene, perforation, or signs of shock, while urgent surgical intervention is indicated for patients with incarcerated rectal prolapse associated with ulceration, bleeding, or acute bowel obstruction and failure of non-operative management 1. It's essential to seek medical evaluation promptly if you experience rectal bleeding, as bleeding can also indicate other serious conditions. Treatment for rectal prolapse-related bleeding focuses on addressing the underlying prolapse, which may require surgical correction depending on severity, and conservative measures like stool softeners, proper toileting habits, and pelvic floor exercises may help manage mild cases and reduce bleeding episodes.
From the Research
Rectal Prolapse and Bleeding
- Rectal prolapse can present with a range of symptoms, including bloody and/or mucous rectal discharge 2.
- The condition is characterized by a circumferential, full-thickness protrusion of the rectum through the anus, which may be intermittent or incarcerated and poses a risk of strangulation 2.
- While rectal prolapse is often associated with symptoms such as pain, incomplete evacuation, and fecal incontinence or constipation, bleeding is also a common symptom 2, 3.
- However, it's worth noting that rectal prolapse is often co-diagnosed with other conditions, such as hemorrhoids, which can also cause bleeding 4.
- The mainstay of management of rectal prolapse is surgical correction, although medical management can be effective in some cases 3, 5, 6.
- Surgical procedures for rectal prolapse are generally classified as abdominal or perineal, and the choice of operation depends on various factors, including the patient's symptoms, bowel habits, anatomy, and pre-operative expectations 2, 5, 6.