What are the possible causes of rectal prolapse?

The rectum is just above the anus and is the last segment of the large bowel. The rectum stores stool till bowel movements are possible. In some patients, part of the rectum can invert and descend or fall out of the anus.

This is termed Rectal Prolapse. Patients may feel a "ball" at the anus or feel as if they are sitting on a lump. Women are six times more likely to suffer rectal prolapse than men.

Rectal prolapse is caused by the weakening of the muscles and ligaments that hold up the rectum in place. Many patients with this condition also have a weak pelvic floor or anal sphincter muscle.

Rectal prolapse is associated with any condition that can cause increased abdominal pressure, or a weakening of the pelvic floor muscles, such as:

1. Chronic constipation and straining to move bowels.
2. The weakening of the muscles with age, especially in patients above the age of 65.
3. Childbirth.
4. Genetic susceptibility.
5. Benign Prostatic Hypertrophy (BPH).
6. Chronic Obstructive Pulmonary Disease (COPD).
7. Congenital conditions such as Hirschsprung’s disease or neuronal intestinal dysplasia.

A rectal prolapse refers to the protrusion of the rectum out of the anus.

There are many factors associated with rectal prolapse. Broadly, the factors that lead to rectal prolapse are divided into factors that weaken the supporting fascia and ligaments of the rectum, factors that weaken the pelvic floor muscle supporting the base of the rectum and factors that caused increased straining during a bowel movement.

Most of the specialists dealing with rectal prolapse believe that it is part of a wider pelvic floor weakness problem. Please look for a colorectal surgeon who has a special interest in pelvic floor disorders. Sometimes, to identify the cause and determine the best approach to treating your rectal prolapse, your surgeon may have to request for some radiologic test or refer you to a urologist or urogynaecologist to assess the other aspects of your pelvic floor.

For further information, you may refer to the link below to understand more about rectal prolapse [1].

References:

1. Dr Lim Jit Fong. Rectal Prolapse - Lim Jit Fong Colorectal Centre. Colorectal-surgery.com.sg. http://www.colorectal-surgery.com.sg/medi_page/site_web_ljf/common_page.asp?pg=52. Published 2011. Accessed January 17, 2020. ‌