Anal or Rectal prolapse refers to a condition in which there is abnormal movement of the lining of the rectum or the entire rectum down through the anal opening. When the tissue protrudes through the anus, it may be up to several inches in length. It primarily occurs in children and in the elderly. The condition may result in prolapse of only the lining of the rectum, the mucosa, or may contain both layers of the rectal wall. The tissue that lines the abdominal cavity, the peritoneum, may also prolapse with the rectum. The preponderance of patients that suffer this disorder are women. It is probably related to weakened or damaged muscles that form the pelvic floor. In children, improvement is often seen after dietary advice and treatment of constipation. Surgery is rarely required in this group of patients.
Causes of Anal Prolapse
In children, rectal or anal prolapse is frequently associated with other medical conditions. These include pinworms, whipworms, malnutrition, celiac disease and cystic fibrosis. In children, it is necessary to exclude other conditions that may be confused with this disorder, such as juvenile rectal polyp and colonic intussusception. In adults, it occurs in relationship to weakened or damaged muscles that form the pelvic floor. This is probably related to childbirth and, accordingly, this condition occurs more commonly in women. In adults, it may also occur after defecation. The mass of tissue may spontaneously retract into the body or stay on the outside. Also, the condition is sometimes seen in people undergoing severe physical stress, such as weight lifters. Here, the pressure within the abdomen reaches such great levels, that a portion of the rectum is forced out of the anus. In adults, it is necessary to exclude disorders that may present similar features. These include large hemorrhoids, rectal tumors, anal polyps and abnormal perineal descent.
Signs and Symptoms of Anal Prolapse
In children, the parents usually notice a mass of tissue extending from the anus. As noted above, it needs to be differentiated from colonic intussusception and juvenile rectal polyps. In adults, it frequently occurs after defection or after severe straining. Mucous may be discharged from the tissue as well as blood.
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Medical Content Last Updated on 07/12/2008
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