Rectal Prolapse in Children

What is Rectal Prolapse?

Rectal prolapse happens when part of the rectum, which is the last part of the large intestine, slips out of the anus. This can happen when a child strains while going to the bathroom, has chronic constipation or has other medical conditions that weaken the pelvic muscles.

While this condition can be concerning for parents, it's important to know that with the right care and treatment, children can recover and find relief. At CHRISTUS Health, we're here to guide you through the diagnosis and treatment options to support your child's well-being.

What Causes Rectal Prolapse?

In the first few years of life, rectal prolapse is uncommon and can usually be resolved without surgery. In children 4 years or older, rectal prolapse is often linked to underlying medical conditions.

Causes of rectal prolapse in children can include:

  • Chronic constipation: If a child strains too hard while trying to pass stool, the rectum can be pushed out.
  • Diarrhea: Loose stools can weaken the muscles and tissues that hold the rectum in place.
  • Cystic fibrosis: This is a genetic condition that causes thick mucus buildup in the lungs, digestive organs, and other systems in the body. The effects of this condition can make it harder for a child to pass stool, causing strain, which can eventually lead to the rectum slipping out of place.
  • Neurological disorders: These conditions can affect muscle control, making prolapse more likely.
  • Malnutrition: Poor nutrition can weaken the muscles supporting the rectum.
  • Frequent coughing or straining: Persistent coughing or other types of pressure can contribute to prolapse.

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Symptoms of Rectal Prolapse in Children

  • A red, bulging mass sticking out from the anus, especially after a bowel movement
  • Mucus or blood in the stool
  • Pain or discomfort when passing stool
  • Difficulty controlling bowel movements

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Pediatric General Surgery Clinic

CHRISTUS Children's General Surgery Clinic in San Antonio provides exceptional surgical care for infants, children, and teens. 

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Medical Management

Most cases of rectal prolapse in children can be managed without surgery. Treatment options include:

  • Dietary Changes: Eating more fiber-rich foods (fruits, vegetables and whole grains) and drinking plenty of water can help soften stools.
  • Stool softeners: These can be prescribed if constipation is a problem.
  • Behavioral changes: Encouraging children to avoid straining and not sit on the toilet for too long can help.
  • Manual reduction: If the rectum does not go back in on its own, a doctor or parent (with medical guidance) can gently push it back.
  • Treatment of underlying conditions: If prolapse is due to a medical condition like cystic fibrosis, treating that condition can help.

Surgical Management

If medical treatments do not work, surgery may be needed. Some surgical options include:

  • Rectopexy: The rectum is reattached to the pelvic floor to prevent it from slipping out. This procedure can be done laparoscopically, which is a minimally invasive method, or through open surgical techniques.
  • Mucosal resection: If the lining of the rectum is loose, a surgeon may perform this surgery to remove some tissue to tighten it.
  • Anal sphincter strengthening procedures: If weak muscles in the anus contribute to the prolapse, surgery can help reinforce them. The anal sphincter muscles are vital in controlling bowel movements.
  • Thiersch suture: A non-absorbable suture or band is placed around the anus to help keep the rectum in place while still allowing normal bowel movements. This minimally invasive procedure is usually recommended for high-risk patients or for patients who are unable to undergo other procedures.
  • Sclerotherapy: A chemical solution is injected into the rectal wall to create scarring and fibrosis, which tightens the tissue over time. This helps anchor the rectum in place. This is a less invasive procedure.

When to See Your Doctor

If your child shows signs of rectal prolapse, schedule an appointment with their doctor, especially if the symptoms continue. While some cases may go away on their own, others will need medical attention to prevent complications or find an underlying cause

Schedule an appointment with your child’s doctor:

  • If prolapse happens repeatedly
  • If there is bleeding or pain
  • If the rectum does not go back inside the body
  • If your child has difficulty controlling bowel movements

Long-term Outlook

Most children with rectal prolapse improve with simple, non-invasive treatments. Surgery is only needed in severe cases. With the right care, rectal prolapse can be successfully managed, and your child can go on to live a normal life.