Rectal prolapse occurs when the rectum loses its normal attachments and descends downward. It may fold inward without becoming visible, involve only the rectal lining, or extend through the anus as a full-thickness prolapse.
Rectal prolapse is different from hemorrhoids. Both can cause bleeding or protruding tissue, but they arise from different anatomy and may require different treatment. An examination by a colorectal specialist can establish the diagnosis.
The term rectal prolapse can describe several related conditions.
The entire wall of the rectum protrudes through the anus. It may initially appear only during a bowel movement and return inside on its own. As it progresses, a person may need to push it back inside, or it may remain outside.
Full-thickness prolapse often appears as a circular segment of red or pink tissue with concentric folds.
Internal rectal prolapse, also called rectal intussusception, occurs when the rectum folds into itself but does not pass through the anus. It may contribute to obstructed defecation, straining, pressure, or incomplete emptying.
Because it is not visible externally, internal prolapse may require defecography or another functional evaluation when the history and examination do not establish the diagnosis.
Mucosal prolapse involves the inner lining of the rectum rather than the full thickness of the rectal wall. It can resemble prolapsing hemorrhoids, making an accurate examination important before treatment is selected.
Rectal prolapse usually develops through a combination of weakened pelvic support, altered bowel function, and repeated pressure or straining. No single cause explains every case.
Associated factors may include:
Constipation may contribute to prolapse, but prolapse can also worsen constipation by interfering with normal evacuation. Some patients experience both constipation and fecal incontinence.
Rectal prolapse often develops gradually. Tissue may first protrude only during a bowel movement and return inside afterward. Over time, it may appear with less effort, require manual reduction, or remain outside.
Progression varies from person to person. Treating constipation, diarrhea, and straining may reduce irritation and bowel-related symptoms, but these measures generally do not anatomically correct an established full-thickness prolapse.
Rectal prolapse does not itself become colorectal cancer. However, bleeding, a new mass, or a change in bowel habits should still be evaluated because other colorectal conditions can produce similar symptoms.
Diagnosis starts with a detailed history and anorectal examination. The clinician may ask when the tissue appears, whether it returns inside, and whether constipation, incomplete emptying, mucus drainage, bleeding, or stool leakage is present.
The examination may include:
If the prolapse is intermittent, a photograph taken by the patient during an episode may sometimes help the clinician understand what occurred, but it does not replace an examination.
Selected patients may need:
See the complete guide to rectal prolapse tests and procedures.
Rectal prolapse and prolapsing hemorrhoids are commonly confused.
| Feature | Full-thickness rectal prolapse | Prolapsing hemorrhoids |
|---|---|---|
| Tissue involved | Full wall of the rectum | Hemorrhoidal tissue from the anal canal |
| Typical appearance | Circular protrusion with concentric folds | Separate columns or lumps |
| Common associated problems | Mucus drainage, constipation, incomplete emptying, stool leakage | Bleeding, itching, irritation, swelling |
| Treatment | Bowel-function management and, for symptomatic full-thickness prolapse, usually surgical repair | Conservative care, office procedures, or surgery depending on severity |
Appearance alone is not enough to confirm either condition. Read the detailed guide to rectal prolapse versus hemorrhoids.
Arrange an evaluation when tissue repeatedly protrudes from the anus, requires manual reduction, or is associated with bleeding, mucus drainage, difficult evacuation, or stool leakage.
Seek urgent medical care if the prolapse cannot be returned inside, becomes dark or dusky, develops severe or rapidly worsening pain, or causes heavy bleeding.
Dr. Aisha Akhtar, MD is a board-certified colon and rectal surgeon who evaluates rectal prolapse and related pelvic-floor conditions for patients in Phoenix, Scottsdale, Glendale, and surrounding Arizona communities.
Schedule a Rectal Prolapse Evaluation or call 602-932-5660.
This page provides general educational information and does not replace an individualized medical examination, diagnosis, or treatment recommendation.
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Dr. Aisha Akhtar, MD provides expert evaluation and treatment of rectal prolapse, including assessment of associated constipation, pelvic floor dysfunction, and fecal incontinence. She offers individualized care ranging from symptom-directed conservative management to advanced surgical repair when indicated.
“ The whole office was wonderful. Dr Akhtar was excellent. She was thorough. She explained things extremely well. She answered all my questions. I... The whole office was wonderful. Dr Akhtar was excellent. She was thorough. She explained things extremely well. She answered all my questions. I never felt like she was rushing my exam. ”
“ Dr. Akhtar and the entire team made what could have been a very stressful experience feel comfortable, reassuring, and genuinely cared for from sta... Dr. Akhtar and the entire team made what could have been a very stressful experience feel comfortable, reassuring, and genuinely cared for from start to finish. Dr. Akhtar was professional, compassionate, and took the time to thoroughly explain everything before my procedure, which immediately put me at ease. The procedure itself went smoothly, and I truly felt I was in excellent hands the entire time. The office staff was also kind, organized, and attentive throughout the process. I’m incredibly grateful for the level of care, patience, and professionalism I received. I would absolutely recommend Dr. Akhtar to anyone looking for a skilled doctor who truly cares about their patients and their comfort. ”
“ I cannot express the how thankful I am for Dr. Akhtar. I had been to 4 other colorectal doctors, 3 gastro doctors before seeing Dr. Akhtar. I was c... I cannot express the how thankful I am for Dr. Akhtar. I had been to 4 other colorectal doctors, 3 gastro doctors before seeing Dr. Akhtar. I was crying in her office when she met me the first time. That didn't deter her. Not only that but she located the issue on my first visit. She is kind, caring, thorough and incredibly knowledgeable. She listens, spends time with you and doesn't talk over you. I've needed extra time to discuss my case many times and she has always taken the time that I needed. I've brought to her research I've read, and she always already knows about the publications. The staff are kind and helpful. I dont know what I would have done without finding her. Another health care provider recommended her highly as do I. ”
“ Best colorectal surgeon I’ve ever met. Dr. Akhtar is compassionate, gentle, warm, and caring. I came to her in Glendale after having a horrific exp... Best colorectal surgeon I’ve ever met. Dr. Akhtar is compassionate, gentle, warm, and caring. I came to her in Glendale after having a horrific experience with a general surgeon in Flagstaff (where I live). The Flagstaff surgeon caused a hemorrhage that almost cost me my life, and then I developed stenosis after the emergency room surgeon “fixed” the hemorrhage. Dr. Akhtar was kind enough to take me as a patient (most surgeons will not take a patient who has already been operated by another surgeon due to liability). She was very respectful and gentle in the examination, and was even able to fit me in for an outpatient procedure under sedation the very same day (knowing that I drove over 2 hours to see her). I could not be happier with her. She took the time to personally call me the next day to check on my progress. You do not see this type of doctor very often anymore. She is someone who is in it for the patient, and you can tell. I will continue to drive over 4 hours there and back to receive her high quality care and expertise. Cannot recommend her highly enough. ”
“ Dr. Akhtar is THE BEST provider I have ever seen, period. She is incredibly knowledgeable, informative, and above all so kind. I have not met... Dr. Akhtar is THE BEST provider I have ever seen, period. She is incredibly knowledgeable, informative, and above all so kind. I have not met many people who have as comforting a bedside manner as she does. I was educated properly every step of the way and felt confident doing so because of her caring demeanor. Her PA Moses is also so friendly and upbeat, helping to ease any tension you may be feeling prior to the exam. The energy both Dr. Akhtar and Moses bring was paramount to how excellent my experience was here. Given their specialty, it would be easy to have an uncomfortable experience. However, they go the extra mile to make sure you are comfortable and reassured before anything is done. I cannot recommend this practice enough. Thank you Dr. Akhtar for the genuine concern and care you provided to me! Both my body and my outlook on my health outcomes are better off because of you. ”
“ Amazing staff and Doctor. So caring and make you feel welcome ”
“ Dr Akhtar has a wonderful bedside manner, explains everything thoroughly and is an exceptionally skilled surgeon. We love her. :) ”
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“ Dr. Aktar was highly recommended by my primary care physician as being a good fit for me. We covered much during this initial visit and all set for... Dr. Aktar was highly recommended by my primary care physician as being a good fit for me. We covered much during this initial visit and all set for a colonoscopy next month. ”
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