Rectal prolapse refers to the protrusion of rectum within and outside of the anal opening.

It is classified according to the extent of the prolapse. This includes:¹

• Internal prolapse – where the rectum has prolapsed internally, but isn’t protruding through the anal opening
• Mucosal prolapse – the inner lining of the rectum protrudes out of the anal opening
• External prolapse – the rectum completely protrudes out of the anal opening

Rectal prolapse is significantly more common in women compared to men, and primarily occurs in children and the elderly.²

Diagnosis of rectal prolapse is generally provided during consultation with a doctor, who will inspect for any signs of rectal protrusion. The patient may be asked to squat and strain/bear down while being observed to identify the prolapse. Other tests that may be undertaken include ultrasounds, special x-rays (such as a proctogram) and analysis of muscle function. A colonoscopy will be necessary to rule out existing polyps or cancer before considering treatment for rectal prolapse.

Treatment for rectal prolapse depends on a number of factors, including your age, prolapse severity and the presence of any existing colorectal conditions.

Treatment options include:^1,2

• Prevention of constipation through diet and lifestyle changes – most successful for rectal prolapse in young children.
• Manual reduction – where the rectal prolapse is reduced using gentle digital pressure, which may be assisted through sedation or local perianal anaesthesia. This is particularly important to prevent strangulation and gangrene of the prolapsed tissue
• Surgery – performed through the abdomen via laparoscopic or open surgery; or through the anus to return the rectum to its normal position