Rectal prolapse is protrusion of rectal tissue, the final section of the large intestine, through the anus to the exterior of the body.


Rectal prolapse in adults is caused by a weakening of the sphincter muscle or ligaments that hold the rectum in place. Weakening can occur because of aging, disease, or in rare cases, surgical trauma. Prolapse is brought on by straining to have bowel movements, chronic laxative use, or severe diarrhea.

Symptoms of rectal prolapse include discharge of mucus or blood, pain during bowel movements, and inability to control bowel movements (fectal incontinence).  Patients may also feel the mass of tissue protruding from the anus. With large prolapses, the patient may lose the normal urge to have a bowel movement.


The exact cause of rectal prolapse is unknown, but risk factors include:

  • chronic constipation,
  • straining to pass bowel motions,
  • weakened pelvic floor muscles,
  • weakened anal sphincter muscles,
  • weakening of the muscles associated with ageing,
  • age over 65 years,
  • genetic susceptibility,
  • parasitic infection,
  • chronic obstructive pulmonary disease (COPD),
  • structural problems with the ligaments that tether the rectum to its surrounds,
  • congenital problems of the bowel.

Risk Factors

Risk factors for children include:

  • Malnutrition.
  • Cystic fibrosis. A child who has rectal prolapse with no obvious cause may need to be tested for cystic fibrosis.
  • Having had surgery on the anus as an infant.
  • Deformities or physical development problems.
  • Straining during bowel movements.
  • Infections.

Risk factors for adults include:

  • Straining during bowel movements because of constipation.
  • Tissue damage caused by surgery or childbirth.
  • Weakness of pelvic floor muscles that occurs naturally with age.


  • Risk of damage to the rectum, such as ulceration and bleeding
  • Incarceration – the rectum cannot be manually pushed back inside the body
  • Strangulation of the rectum – the blood supply is reduced
  • Death and decay (gangrene) of the strangulated section of the rectum.


To help reduce your chance of rectal prolapse, take the following steps:

  • Eat a healthy diet that is high in fiber.
  • Exercise regularly.
  • To train your bowels, create a routine. For example, try to go to the bathroom after lunch each day.
  • Do not rush when moving your bowels.
  • If you feel the urge to move your bowels, respond by going to the bathroom

In children, treating the underlying condition usually prevents further rectal prolapse. Treating vascular constipation is an important preventive measure.