Can rectal prolapse cause bleeding during bowel movements?

Written by Deng Heng
Colorectal Surgery
Updated on December 13, 2024
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Patients with rectal prolapse may experience bleeding during bowel movements. The primary symptom of rectal prolapse is a protrusion of a swelling through the anus. Initially, the swelling is small and only protrudes during bowel movements, retracting on its own afterwards. As the condition progresses, due to a lack of contraction strength in the levator ani and anal sphincter muscles, the prolapse occurs more frequently and increases in size, requiring manual repositioning back into the anus after defecation. If not repositioned timely, the prolapsed intestinal tract can become edematous, constricted, or even necrotic, which may result in bloody stools.

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Written by Deng Heng
Colorectal Surgery
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Is rectal prolapse the same as hemorrhoids?

Rectal prolapse and hemorrhoids are two different diseases. Rectal prolapse refers to the condition where the rectal mucosa, or sometimes the entire rectal wall, prolapses downwards during defecation, prolonged standing, or fatigue, especially in severe cases. Hemorrhoids, on the other hand, involve the prolapse of vascular cushions and anal padding, sometimes accompanied by symptoms like rectal bleeding. The causes, mechanisms, pathology, symptoms, and treatment methods of these two conditions are distinct, making rectal prolapse and hemorrhoids two separate diseases.

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Written by Chen Tian Jing
Colorectal Surgery
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Causes of rectal prolapse

The causes of rectal prolapse primarily include older age or physical weakness leading to relaxation and sagging of the pelvic and rectal mucosa. Prolonged constipation can also lead to excessive straining during bowel movements, causing stress-induced sagging of the intestinal mucosa. Additionally, women who have gone through childbirth may experience rectal prolapse due to excessive straining of the pelvic floor muscles during delivery or increased abdominal pressure during pregnancy, which compresses the rectal mucosa. The treatment for rectal prolapse mainly consists of conservative medication or surgical removal. For mild cases of rectal prolapse, including those in children, traditional Chinese medicine enemas can be used. However, for moderate to severe cases, or cases where prolapse recurs frequently and significantly forms a complete prolapse, surgical removal is recommended.

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Written by Chen Tian Jing
Colorectal Surgery
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Can you eat pork with rectal prolapse?

Patients with rectal prolapse can eat pork. Rectal prolapse is common in patients who have had chronic constipation or are physically weak. Therefore, to avoid constipation and excessive straining during bowel movements, it is recommended that patients with rectal prolapse maintain a diet that is light and bland. They should avoid spicy foods such as chili peppers and seafood, as well as foods that are hard in texture, to prevent stools from becoming too dry and necessitating excessive straining, which can worsen the prolapse or even lead to complete rectal prolapse. To prevent the recurrence of constipation or excessive straining during bowel movements, it is advisable to consume more liquid foods, as well as light vegetables and fruits. Moreover, if the condition frequently recurs or clearly leads to complete rectal prolapse, it is recommended that patients undergo surgical treatment as soon as possible.

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Colorectal Surgery
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How to check for rectal prolapse?

Rectal prolapse is generally divided into internal rectal mucosal prolapse and external prolapse, also known as rectal procidentia. If it is an internal prolapse, an anoscopy combined with defecography is required to examine the degree of laxity of the local rectal mucosa. If it is an external prolapse or rectal procidentia, the patient generally presents with a prolapsed swelling when squatting, and this can be further evaluated with a digital rectal examination to assess the local tightness of the anus. If rectal prolapse occurs, surgical treatment is recommended as it tends to be quite effective. In cases of pediatric prolapse or mild prolapse, traditional Chinese medicine enemas may be used to alleviate local symptoms.

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How is rectal prolapse graded?

Rectal prolapse is generally graded into three degrees: first degree rectal prolapse, second degree rectal prolapse, and third degree rectal prolapse. First degree rectal prolapse is a relatively minor condition where the rectal mucosa protrudes but can retract back on its own. Second degree rectal prolapse is a moderate condition where the protruding mucosa extends approximately 5-10 centimeters, generally forming a conical shape, and requires the patient to manually reposition it. Third degree rectal prolapse indicates a severe condition, with the prolapsed mucosa typically extending beyond 10 centimeters. It may protrude with each incident and could also occur when the patient strains the abdomen or squats. The treatment of second and third degree rectal prolapse generally requires surgical intervention.