A prolapsed bowel is a medical condition where the walls of the rectum protrude through the anus. Caused by a weakness of the ligaments and muscles that hold the rectum in place, this condition is common among individuals of advanced age and children. How this condition is treated depends on the degree of protrusion and the severity of symptoms.
A partial prolapse is common in young children and occurs when the lining of the rectum protrudes from the anus. When the walls of the rectum protrude from the anus, it is considered a complete prolapse. Initially occurring during bowel movements, a complete prolapse progresses until protrusion occurs upon standing or moving, and eventually remaining outside the body. An internal prolapse, known as intussusception, occurs when the wall of the colon or rectum collapses onto itself inside the body.
There are a variety of factors that may contribute to the development of a prolapsed bowel. Children may be at an increased risk of developing this condition if they are prone to infections, are malnourished, or strain during bowel movements. Individuals with certain disorders, such as chronic obstructive pulmonary disease (COPD) and cystic fibrosis, may be at an increased risk for developing a prolapse due to the physical strain, as induced with persistent coughing, associated with such conditions. Additional factors that may promote this problem include advanced age, long-term diarrhea or constipation, and pregnancy.
Individuals with a prolapsed bowel may experience a variety of symptoms that occur in stages. Initially, rectal prolapse may cause fecal incontinence, or an inability to control one’s bowels. There may also be a mucus-based or bloody discharge from the anus, a condition known as wet anus. Symptomatic individuals may exhibit additional signs that may include rectal discomfort, a feeling of urgency that accompanies bowel movements, and a visible protrusion of red tissue from the anus.
Prior to making a diagnosis of rectal prolapse, a medical professional may ask a variety of questions regarding the individual’s medical history, current symptoms, and diet. A physical examination will be conducted, during which the individual may be asked to sit on a toilet and strain. In the event that no protrusion occurs, an enema may be administered. An evaluation of bowel control may also be conducted, known as a defecogram, which helps to determine the extent of the prolapse.
Mild cases, especially in children, generally subside with time. Dietary changes, such as increasing fiber intake, or the use of laxatives or stool bulking products are usually recommended for cases of partial prolapse. Individuals whose partial prolapse does not respond to recommended changes may require surgical repair. In cases of partial or complete prolapse, a procedure known as rectopexy is performed to affix the rectum to either the lower portion of the spine or the pelvic floor to prevent protrusion and restore proper function.