Causes
Rectal prolapse is caused by the weakening of the ligaments and muscles that hold the rectum in place. In most people, the anal sphincter is weak. Rectal prolapse is often associated with the following conditions: advanced age, long term constipation, long term diarrhea, long term straining during defecation, pregnancy and stresses of childbirth, previous surgery, cystic fibrosis, COPD, and sphincter paralysis.
Progression
The condition of Rectal prolapse, a type of rectal rupture, undergoes progression: beginning with prolapsation during bowel movements, through Valsalva movements (sneezing and so forth), then through daily activities such as walking until finally it may become chronic and ceases to retract.
Treatment
Partial prolapse may be treated by a diet high in fiber.[citation needed]
Pharmaceutically, the condition may only be treated secondarily (by treating deficate) so as to avoid further straining.
The alternative is surgery. It may be divided into two forms of procedure: abdominal surgery and perineal surgery.
Abdominal surgery - for younger patients, but is more dangerous
Anterior resection
Marlex rectopexy
Suture rectopexy
Resection rectopexy
Perineal surgery - often performed on older patients and is less dangerous
Anal encirclement
Delorme mucosal sleeve resection
Altemeier perineal rectosigmoidectomy
Hemorrhoidectomy
Children are treated with linear cauterization
Recently, robotic-assisted surgery has been introduced as a treatment option.
Notes
Because most sufferers are elderly, the condition is generally under-reported.
The condition can also occur in children.
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