Rectal prolapse

Rectal procidentia; Rectal intussusception

Rectal prolapse occurs when the rectum sags and comes through the anal opening.

Causes

The exact cause of rectal prolapse is unclear. Possible causes may include any of the following:

An enlarged opening due to relaxed muscles in the pelvic floor, which is formed of muscles around the rectum
Loose muscles of the anal sphincter
An abnormally long colon
Downward movement of the abdominal cavity between the rectum and uterus
Prolapse of the small intestine
Constipation
Constipation
Constipation in infants and children means they have hard stools or have problems passing stools. A child may have pain while passing stools or may ...
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Diarrhea
Diarrhea
Diarrhea is when you pass loose or watery stool.
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Chronic coughing and sneezing

A prolapse can be partial or complete:

With a partial prolapse, the inner lining of the rectum bulges partly from the anus.
With a complete prolapse, the entire rectum bulges through the anus.

Rectal prolapses occur most often in children under age 6 years. Health problems that may lead to prolapse include:

Cystic fibrosis
Cystic fibrosis
Cystic fibrosis is a disease that causes thick, sticky mucus to build up in the lungs, digestive tract, and other areas of the body. It is one of th...
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Intestinal worm infections
Long-term diarrhea
Other health problems present at birth

In adults, it usually occurs in people with constipation, or with a muscle or nerve problem in the pelvic or genital area.

Symptoms

The main symptom is a reddish-colored mass that sticks out from the opening of the anus, especially after a bowel movement. This reddish mass is actually the inner lining of the rectum. It may bleed slightly and can be uncomfortable and painful.

Exams and Tests

Your health care provider will perform a physical exam, which will include a rectal exam. To check for prolapse, the provider may ask the person to bear down while sitting on a toilet.

Tests that may be done include:

Colonoscopy to confirm the diagnosis
Colonoscopy
A colonoscopy is an exam that views the inside of the colon (large intestine) and rectum, using a tool called a colonoscope. The colonoscope has a sm...
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Blood test to check for anemia if there is bleeding from the rectum
Blood test
Hemoglobin is a protein in red blood cells that carries oxygen. The hemoglobin test measures how much hemoglobin is in your blood.
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Cinedefecography, a real-time X-ray test to evaluate the function of the rectum and pelvic floor

Treatment

Contact your provider if a rectal prolapse occurs.

In some cases, the prolapse can be treated at home. Follow your provider's instructions on how to do this. The rectum must be pushed back inside manually. A soft, warm, wet cloth is used to apply gentle pressure to the mass to push it back through the anal opening. The person should lie on one side in a knee-chest position before applying pressure. This position allows gravity to help put the rectum back into position.

Immediate surgery is rarely needed. In children, treating the cause often solves the problem. For example, if the cause is straining because of dry stools, laxatives may help. If the prolapse continues, surgery may be needed.

In adults, the only cure for a rectal prolapse is a procedure that repairs the weakened anal sphincter and pelvic muscles, and removes or repositions part of the colon and rectum.

Outlook (Prognosis)

In children, treating the cause cures rectal prolapses. In adults, surgery usually cures the prolapse.

When a rectal prolapse is not treated, constipation and loss of bowel control may develop.

When to Contact a Medical Professional

Contact your provider right away if there is a rectal prolapse.

Prevention

In children, treating the cause usually prevents a rectal prolapse from happening again.

Open References

References

Bleier JIS, Hernandez PT, Lowenfeld L. Benign anorectal disorders. In: Tyler DS, Hayes-Dixon A, Hines OJ, et al, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 22nd ed. Philadelphia, PA: Elsevier; 2026:chap 97.

Kliegman RM, St. Geme JW, Blum NJ, et al. Surgical conditions of the anus and rectum. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 392.

Madoff RD, Melton GB. Diseases of the rectum and anus. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 131.

Rectal prolapse - illustration
Rectal prolapse may be partial, involving only the mucosa or complete, involving the entire wall of the rectum.
Rectal prolapse
illustration
Rectal prolapse repair - series
Presentation

<strong>Rectal prolapse repair - series</strong><p>The rectum is the final portion of the large intestine. It empties stool from the body through the anus. The rectum is anchored in position by ligaments. When these ligaments weaken, the rectum can move out of its normal position, downward, and pass through the anus. This is called rectal prolapse.</p>

<strong>Indications</strong><p>Rectal prolapse may be partial, involving only the mucosa or complete, involving the entire wall of the rectum. Children with myelomeningocele and bladder exstrophy as well as children with cystic fibrosis are particularly at risk. Rarely it can be caused by acute diarrhea or straining while passing constipated stool. Most cases of prolapse do not require surgical correction. Infant prolapse often disappears without intervention. Rectal prolapse repair is advised for a continued rectal prolapse that does not clear up or is unresponsive to treatment of an underlying condition.</p>

<strong>Procedure</strong><p>General anesthesia is used and the patient is deep asleep and pain-free. The surgeon makes an incision near the base of the spinal column (coccyx), and identifies the pelvic floor (perineal) support structures. The lower rectum is sutured to the puborectalis muscle for support, while the upper part of the rectum is pulled up and sutured to the sacrum.</p>

<strong>Aftercare</strong><p>The surgery is usually effective in repairing the prolapse. The long-term prognosis is excellent. Usually only 1 or 2 days of hospitalization is all that is required. Expect complete recovery within 4 weeks.</p>

Rectal prolapse - illustration
Rectal prolapse may be partial, involving only the mucosa or complete, involving the entire wall of the rectum.
Rectal prolapse
illustration
Rectal prolapse repair - series
Presentation

A Closer Look

Self Care

Tests for Rectal prolapse

Review Date: 4/11/2026

Reviewed By: Ann M. Rogers, MD, FACS, Professor Emeritus, Department of Surgery, Penn State College of Medicine, Hershey, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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Health Library

Rectal prolapse

Causes

Constipation

Diarrhea

Cystic fibrosis

Symptoms

Exams and Tests

Rectal exam

Colonoscopy

Blood test

Treatment

Procedure

Outlook (Prognosis)

Loss of bowel control

When to Contact a Medical Professional