The walls of the rectum protrude through the opening of the anus and become visible
Aetiology
Most common in the elderly but can occur in all ages, including children
Risk factors
Increasing age
Female gender
Multiple deliveries
Straining
Previous traumatic vaginal delivery
Pathophysiology
Partial thickness: rectal mucosa protrudes out of the anus
Full thickness: rectal wall protrudes out the anus
Most common in elderly females
Clinical presentation
Protruding mass from anus especially during defecation
May reduce spontaneously
Bleeding and passing mucus per rectum common
Examination shows poor anal tone
Investigations
Barium enema and/or colonoscopy to evaluate the entire colon prior to surgery
Other investigations to assess underlying conditions (as indicated) include stool microscopy and cultures for gastrointestinal infection and sweat test for cystic fibrosis
Management
Complete prolapse
Many patients are too frail for surgery - bulking agent and education on manual reduction
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