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Rectal prolapse is when the tissue that lines the rectum falls down into or sticks through the anal opening.

Rectal prolapse occurs most often in children under age 6 and in the elderly. It is often associated with the following conditions:

• Constipation
• Cystic fibrosis
• Malnutrition and malabsorption (celiac disease is an example)
• Pinworms (enterobiasis)
• Prior injury to the anus or pelvic area
• Whipworm infection (trichuriasis)

The main symptom is a reddish-colored mass that sticks out from the opening of the anus, especially following a bowel movement. The lining of the rectal tissue may be visible and may bleed slightly.

The health care provider will perform a physical exam, which may include a rectal exam. Tests will be done to determine the underlying cause.

Call your health care provider if a rectal prolapse occurs. In some cases, the prolapse can be treated at home.

The rectal mucosa must be returned to the rectum manually. A soft, warm, wet cloth is used to apply gentle pressure to the mass to push it back through the anal opening. The affected person should be in a knee-chest position before applying pressure to allow gravity to help return the prolapse.

Immediate surgery for repair is seldom needed. The underlying condition must be treated.

Treating the underlying condition usually cures the problem. In otherwise-healthy elderly patients with recurrent rectal prolapse, surgery can repair anatomic problems that predispose them to prolapse.

• Constipation
• Malnutrition or malabsorption
• Other complications of the condition that caused the prolapse

Call your health care provider promptly if there is a rectal prolapse.

Treating the underlying condition usually prevents further rectal prolapse.

Updated by: Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Jefferson Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.