Rectal prolapse can be alarming, uncomfortable, and often embarrassing to talk about. Many people first notice a soft bulge coming out of the anus during bowel movements, along with symptoms like leakage, mucus discharge, or difficulty fully emptying the bowels.
The most important thing to know is this: rectal prolapse is treatable, and many people get excellent relief with the right plan. Treatment depends on how severe the prolapse is, your overall health, and whether you have related pelvic floor issues like constipation, urinary incontinence, or pelvic organ prolapse.
This guide explains the most effective ways to fix rectal prolapse, including conservative management, medical evaluation, and surgical repair options.
What Is Rectal Prolapse?
Rectal prolapse occurs when the rectum (the last part of the large intestine) slips down and protrudes through the anus. It can range from mild to severe.
Types of Rectal Prolapse
1. Partial (Mucosal) Prolapse
Only the inner lining of the rectum protrudes.
2. Full-Thickness Rectal Prolapse
The entire rectal wall protrudes outward. This is more serious and usually requires surgery.
3. Internal Rectal Prolapse (Intussusception)
The rectum folds into itself but does not protrude externally. This can still cause symptoms.
What Causes Rectal Prolapse?
Rectal prolapse is often caused by weakened pelvic floor support and chronic straining. It can happen in both men and women, but is more common in older women.
Common Causes and Risk Factors
- Chronic constipation and straining
- Long-term diarrhea
- Pelvic floor dysfunction
- Pregnancy and childbirth (especially multiple vaginal deliveries)
- Aging and loss of muscle tone
- Prior pelvic surgery
- Neurologic conditions (such as spinal injury)
- Weak anal sphincter muscles
Rectal prolapse may also occur alongside pelvic organ prolapse, which is why evaluation by a pelvic health specialist can be important.
Symptoms of Rectal Prolapse
Rectal prolapse symptoms can be mild at first and worsen over time.
Common Symptoms
- A visible bulge coming out of the anus
- Rectal bleeding or irritation
- Mucus discharge
- Fecal incontinence or stool leakage
- Feeling of incomplete bowel emptying
- Pain or pressure in the rectal area
- Worsening symptoms after bowel movements or standing
Can Rectal Prolapse Be Fixed Without Surgery?
This is one of the most searched questions, and the honest answer is:
Mild cases can sometimes be managed, but full rectal prolapse usually requires surgery.
Conservative treatment can help:
- Reduce symptoms
- Prevent worsening
- Improve bowel function
- Support pelvic floor strength
But it typically does not permanently reverse full prolapse.
How to Fix Rectal Prolapse: Best Treatment Options
Treatment is usually divided into two categories:
- Conservative (non-surgical) management
- Surgical repair
Your best option depends on the severity of prolapse, symptoms, and your overall health.
Conservative Treatment for Rectal Prolapse (Non-Surgical)
1. Treat Constipation and Reduce Straining
Straining is one of the biggest drivers of prolapse progression.
Helpful strategies include:
- Increasing fiber intake (through food or supplements)
- Drinking enough water daily
- Using stool softeners when needed
- Avoiding prolonged sitting on the toilet
Goal: soft, formed stools that pass without pushing.
2. Pelvic Floor Physical Therapy
Pelvic floor therapy can help improve muscle coordination and support.
It may help with:
- Better bowel emptying
- Reduced prolapse symptoms
- Improved anal sphincter strength
- Reduced fecal leakage
A pelvic floor therapist can also teach safe techniques like proper breathing and defecation mechanics, which reduces pressure on the rectum.
3. Bowel Training and Toilet Posture
Small changes can reduce pressure on the rectum.
Tips:
- Use a footstool to elevate knees above hips
- Exhale during bowel movements (do not hold your breath)
- Avoid forcing stool out
- Go when you feel the urge, but do not “try” repeatedly
4. Manual Reduction (If the Prolapse Comes Out)
Some patients can gently push the prolapse back in after a bowel movement.
Important safety notes:
- Use clean hands and gentle pressure
- Lying down may help
- A cold compress can reduce swelling
- If it becomes painful, stuck, or dark purple, seek urgent care
Manual reduction is not a permanent fix, but it may prevent swelling and discomfort.
When Rectal Prolapse Needs Surgery
Surgery is generally recommended when:
- The prolapse is full-thickness
- It happens frequently or stays out
- You have bleeding, ulcers, or significant pain
- You have fecal incontinence or worsening bowel function
- Conservative treatment is not helping
Rectal prolapse does not typically go away on its own and often worsens over time, especially with continued straining.
Rectal Prolapse Surgery Options
There are multiple surgical approaches. The best one depends on age, health status, prolapse severity, and whether constipation or incontinence is present.
Overview of Surgical Approaches
| Surgery Type | Approach | Common Candidates | Key Notes |
|---|---|---|---|
| Rectopexy | Abdominal (laparoscopic/robotic) | Healthier patients | Strong long-term results |
| Perineal repair | Through the perineum/anus | Older or higher-risk patients | Less invasive, higher recurrence |
| Resection rectopexy | Abdominal | Patients with constipation | Removes redundant colon + secures rectum |
Abdominal Rectopexy (Laparoscopic or Robotic)
Rectopexy is one of the most common procedures for full rectal prolapse.
How it works
The rectum is repositioned and secured to prevent it from slipping downward again.
Benefits
- Lower recurrence rates than perineal approaches
- Often performed minimally invasively
- Good long-term outcomes
Considerations
Some patients may develop constipation afterward, so surgeons may tailor the technique depending on bowel patterns.
Resection Rectopexy (If Constipation Is a Major Problem)
This surgery combines rectopexy with removal of a portion of the sigmoid colon.
Best for:
- Rectal prolapse with chronic constipation
- Redundant colon contributing to symptoms
Perineal Surgery (Delorme or Altemeier Procedures)
Perineal procedures are done through the anus or perineum and are often used for older adults or those who are not ideal candidates for abdominal surgery.
Delorme Procedure
Used for smaller prolapses, involves removing mucosal tissue and tightening muscle.
Altemeier Procedure (Perineal Rectosigmoidectomy)
Used for larger prolapses, involves removing part of the rectum and sigmoid colon through the perineum.
Recovery After Rectal Prolapse Surgery
Most people recover well, but recovery time depends on the procedure type.
Typical recovery timeline
- First 1 to 2 weeks: rest, stool softeners, avoid straining
- 2 to 6 weeks: gradual return to normal activities
- 6+ weeks: full healing for many patients
Post-surgery tips to prevent recurrence
- Avoid heavy lifting during recovery
- Keep stools soft and easy to pass
- Follow pelvic floor therapy if recommended
- Treat chronic cough (if present)
- Maintain healthy body weight
What Not to Do If You Have Rectal Prolapse
Some common mistakes can worsen symptoms.
Avoid:
- Ignoring constipation
- Repeated straining
- Heavy lifting without proper technique
- Overusing stimulant laxatives
- Waiting too long if the prolapse is worsening
When Rectal Prolapse Is an Emergency
Seek urgent medical care if:
- The prolapse becomes stuck and cannot be reduced
- The tissue turns dark purple, black, or very swollen
- You have severe pain, fever, or heavy bleeding
- You cannot pass stool or gas
These signs may indicate reduced blood flow to the tissue.
FAQs:
1. Can rectal prolapse heal on its own?
Rectal prolapse typically does not heal on its own. Mild symptoms may improve with conservative care, but full prolapse usually requires surgical repair.
2. What is the best treatment for rectal prolapse?
The best treatment depends on severity and overall health. Full-thickness prolapse is most effectively treated with surgery, such as rectopexy or perineal repair.
3. Can pelvic floor exercises fix rectal prolapse?
Pelvic floor exercises can reduce symptoms and improve support, but they usually cannot permanently correct full rectal prolapse.
4. How do you push rectal prolapse back in safely?
Some people can gently reduce prolapse using clean hands and light pressure, often while lying down. If it is painful, swollen, or discolored, seek urgent care.
5. What happens if rectal prolapse is left untreated?
Untreated rectal prolapse often worsens over time and may lead to bleeding, irritation, ulcers, and worsening fecal incontinence.
6. How long is recovery after rectal prolapse surgery?
Recovery varies by procedure, but many people return to normal daily activity within 2 to 6 weeks. Full healing may take longer depending on the surgery type.
Summary: How to Fix a Rectal Prolapse Safely
Rectal prolapse is a real medical condition that can significantly affect comfort, confidence, and quality of life. While lifestyle changes and pelvic floor therapy can reduce symptoms, full rectal prolapse usually requires surgical repair for long-term relief.
The best outcomes come from early diagnosis, proper bowel management, and individualized treatment from a pelvic health specialist.
Get Expert Pelvic Floor and Prolapse Care in Riverside
If you are experiencing rectal prolapse symptoms, constipation, leakage, or pelvic pressure, professional evaluation matters. At California Urogynecology Center, Dr. Bilal Kaaki provides advanced, patient-centered care for pelvic floor disorders and prolapse, including treatment options tailored to your needs.