Rectal Prolapse Symptoms and Warning Signs

The most recognizable symptom of external rectal prolapse is red or pink tissue protruding through the anus, often during or after a bowel movement. Other symptoms can include rectal pressure, mucus drainage, bleeding, incomplete emptying, constipation, and difficulty controlling gas or stool.

Symptoms may be intermittent at first. The tissue may return inside on its own, need to be pushed back manually, or remain outside as the prolapse progresses.

Common Symptoms of Rectal Prolapse

Patients may experience one or more of the following:

• A bulge or circular segment of tissue coming through the anus
• A feeling that something is falling out
• Rectal pressure, fullness, or pelvic heaviness
• Mucus discharge or persistent moisture
• Bright-red bleeding or irritation
• Constipation or repeated straining
• A sensation of incomplete evacuation
• Difficulty controlling gas
• Stool leakage, soiling, or fecal incontinence
• The need to manually push tissue back inside

Not every patient has every symptom. Some people mainly experience obstructed bowel movements, while others first notice protruding tissue or leakage.

What Does a Prolapsed Anus Feel Like?

People describe rectal prolapse in different ways. It may feel like:

• A lump or soft mass at the anus
• Tissue slipping or falling out during a bowel movement
• Pressure in the rectum or pelvis
• A sensation of sitting on a small ball
• An urge to have another bowel movement after finishing
• A blockage that makes stool difficult to pass
• Dampness or irritation caused by mucus leakage

External prolapse is not always painful. New severe pain, rapidly increasing swelling, or tissue that cannot be returned inside is more concerning and needs prompt assessment.

Visible Signs of External Rectal Prolapse

Full-thickness rectal prolapse often appears as a red or pink circular protrusion with concentric folds. It may:

• Appear only while straining
• Remain visible briefly after a bowel movement
• Return inside on its own
• Require gentle manual reduction
• Become larger or appear with standing, coughing, or routine activity as it progresses

Online photographs cannot reliably confirm the diagnosis. Prolapsing hemorrhoids, mucosal prolapse, polyps, and other anorectal conditions may produce a visible lump or protruding tissue. See rectal prolapse images and medical diagrams for educational illustrations.

Bowel-Movement Symptoms

Rectal prolapse may interfere with normal evacuation. Symptoms can include:

• Longstanding constipation
• Excessive straining
• Incomplete emptying
• Repeated trips to the bathroom
• The need to change position or manually assist evacuation
• Alternating constipation and stool leakage

Prolapse can contribute to obstructed evacuation, while chronic constipation and straining may also worsen prolapse. A colorectal evaluation can help identify which problems are occurring together.

Mucus, Bleeding, and Skin Irritation

Exposed rectal tissue may become irritated and produce mucus or bleeding. Patients may notice:

• Mucus on underwear or toilet tissue
• Moisture, itching, or irritated skin around the anus
• Bright-red blood on toilet paper or the stool surface
• Bleeding from tissue that repeatedly rubs against clothing

Rectal bleeding should not automatically be attributed to prolapse or hemorrhoids. Other colorectal conditions can cause bleeding and may require separate evaluation.

Stool Leakage and Fecal Incontinence

Full-thickness prolapse can stretch the anal sphincter and interfere with closure of the anal canal. This may cause:

• Difficulty controlling gas
• Mucus or stool seepage
• Urgency
• Soiling between bowel movements
• Complete loss of bowel control in more advanced cases

The duration of prolapse, sphincter function, and nerve function can affect whether continence improves after treatment.

Internal Rectal Prolapse Symptoms

Internal rectal prolapse does not extend outside the anus, so there may be no visible bulge. Possible symptoms include:

• Obstructed defecation
• Persistent straining
• Incomplete evacuation
• Rectal or pelvic pressure
• The need to manually assist bowel movements

These symptoms overlap with several pelvic-floor disorders. Defecography or other testing may be recommended when internal prolapse is suspected.

Rectal Prolapse or Hemorrhoids?

Both conditions may cause protruding tissue and bright-red bleeding. Full-thickness rectal prolapse typically involves a circular segment of rectum with concentric folds, while prolapsing hemorrhoids arise from the anal canal and often form separate columns or lumps.

Because photographs and symptoms can be misleading, do not select treatment based on appearance alone. Read rectal prolapse versus hemorrhoids and arrange an examination when the diagnosis is uncertain.

When Should You See a Doctor?

Schedule a medical evaluation when:

• Tissue repeatedly protrudes through the anus
• The prolapse must be pushed back inside
• Bleeding or mucus drainage persists or returns
• Constipation or incomplete emptying is worsening
• Stool leakage or loss of bowel control develops
• The tissue is becoming larger or appears more frequently
• Symptoms interfere with hygiene, sleep, work, exercise, or daily activities

A specialist can determine whether the problem is full-thickness prolapse, internal prolapse, mucosal prolapse, hemorrhoids, or another condition.

When Is Rectal Prolapse an Emergency?

Seek urgent medical care if:

• Prolapsed tissue cannot be returned inside
• The tissue becomes dark, dusky, purple, gray, or black
• Severe or rapidly worsening pain develops
• Swelling increases quickly
• Heavy or continuous bleeding occurs
• Fever, fainting, or marked weakness is present

These findings can indicate trapped tissue or reduced blood supply. Learn more about rectal prolapse emergencies.

How Symptoms Are Evaluated

Evaluation usually begins with a history and anorectal examination, sometimes while bearing down. Selected patients may need defecography, anorectal manometry, colonic transit testing, or colonoscopy depending on their symptoms.

Read about rectal prolapse tests and procedures or review what rectal prolapse is and how it is diagnosed.

Rectal Prolapse Symptom Evaluation in Phoenix

Persistent protruding tissue, bleeding, mucus drainage, difficult evacuation, or stool leakage deserves an accurate diagnosis.

Dr. Aisha Akhtar, MD is a board-certified colon and rectal surgeon who evaluates rectal prolapse and related colorectal conditions for patients in Phoenix, Scottsdale, Glendale, and surrounding Arizona communities.

Schedule a Rectal Prolapse Evaluation or call 602-932-5660.

If rectal prolapse has already been diagnosed, explore rectal prolapse treatment and surgery in Phoenix.

Medical Sources

• American Society of Colon and Rectal Surgeons: Rectal Prolapse
• ASCRS Clinical Practice Guidelines for the Treatment of Rectal Prolapse

This page provides general educational information and does not replace an individualized medical examination, diagnosis, or treatment recommendation.

Learn More About Rectal prolapse

You may also explore these guides:

• Rectal prolapse Overview
• Rectal prolapse Symptoms
• Rectal prolapse Procedures
• Rectal prolapse FAQ
• Rectal prolapse Images & Diagrams