Rectal Prolapse

The protrusion of the rectal wall through the anal opening.

• Full-thickness prolapse: The entire wall of the rectum protrudes.
• Mucosal prolapse: Only the mucosal layer protrudes.

• Chronic straining during defecation.
• Chronic constipation or diarrhoea.
• Pelvic floor dysfunction.
• Prior pelvic surgeries.
• Age-related changes in pelvic muscles and supporting structures.

• Visible protrusion from the anus, especially post-defecation.
• Feeling of incomplete evacuation.
• Mucus discharge or bleeding.
• Faecal incontinence in some cases.

• Clinical examination: Inspection and digital rectal examination.
• Proctosigmoidoscopy: To rule out other pathologies.
• Anorectal manometry: To assess anal sphincter function.

• Conservative: Stool softeners, high-fibre diet, pelvic floor physiotherapy.
• Surgical:
  • Abdominal procedures such as rectopexy.
  • Perineal procedures like Altemeier’s procedure (perineal rectosigmoidectomy).

• Chronic ulceration or necrosis due to compromised blood supply.
• Recurrence after surgical repair.
• Strangulation (rare).

• Address underlying causes such as chronic constipation.
• Regular pelvic floor exercises to strengthen supporting muscles.

Recognising rectal prolapse and differentiating it from other conditions like haemorrhoids is essential for accurate treatment and management.