Rectal prolapse, a condition predominantly affecting women over the age of 50, often remains shrouded in misunderstanding despite its significant impact on daily life. This condition arises when the rectum, which forms the final segment of the large intestine, descends through the anus. This descent can lead to discomfort, social embarrassment, and a host of potential health issues. Early symptom recognition and an understanding of effective treatments are vital to managing this delicate health concern and enhancing one’s quality of life. Here, we delve into the nuances of rectal prolapse, focusing on symptoms, causes, diagnosis, home care strategies, and identifying when to seek medical assistance urgently.

What Is Rectal Prolapse?

Rectal prolapse involves the outward slipping of the rectum through the anus. This can manifest as a partial prolapse, where only the rectal lining protrudes, or as a complete prolapse, marked by the full thickness of the rectal wall visibly extending outside the body. According to Alexandra Dubinskaya, MD, a urogynecologist and expert in intimate health, “Rectal prolapse is much more common than most people think.” It is particularly prevalent in women over 50, often associated with aging and weakened pelvic muscles. The onset can be gradual or sudden, with varying degrees of severity. While not immediately life-threatening, the condition can disrupt bowel control and diminish life quality, necessitating prompt attention to prevent further deterioration.

Rectal Prolapse Symptoms Women Should Never Ignore

Timely recognition is crucial for managing rectal prolapse effectively. Women should remain vigilant for these symptoms:

• A noticeable bulge or protrusion from the anus, particularly following bowel movements.

• A persistent sensation of incomplete bowel evacuation or the feeling that something is descending from the body.

• Frequent discomfort, pain, or irritation around the anus

• Mucus discharge or bleeding from the rectum

• Fecal incontinence or difficulty controlling bowel movements

• Straining during bowel movements becomes increasingly necessary

• A feeling of pressure or fullness in the pelvic area

Ignoring these symptoms often results in worsening prolapse and complications such as chronic inflammation or ulceration of prolapsed tissue. Prompt medical evaluation can provide relief and prevent long-term damage.​

What Causes Rectal Prolapse?

Several factors contribute to the development of rectal prolapse, especially in women over 50:

• Chronic Constipation: Frequent straining during bowel movements weakens pelvic muscles and increases pressure on the rectum.

• Poor Posture: Sitting or straining improperly during toileting can exacerbate prolapse.

• Too Many Kegels: While Kegel exercises strengthen pelvic floor muscles, overdoing them without balance can cause muscle imbalance.

• Hormone Changes at Midlife: Decreased estrogen levels at menopause contribute to weakening of pelvic tissue and muscles.

Other contributory factors include previous childbirth injuries, genetic predisposition, and increased abdominal pressure from obesity or heavy lifting. Addressing these underlying causes is integral to effective treatment.​

How Rectal Prolapse Is Diagnosed

Diagnosis begins with a detailed medical history and physical examination, often including:

• Visual inspection of the anus during straining

• Digital rectal exam to assess muscle tone and rectal prolapse extent

• Occasionally, imaging tests such as defecography or MRI to evaluate pelvic floor structure

Specialists may also test for associated conditions like nerve damage or incontinence. Early diagnosis enables more conservative treatment approaches to be effective and prevents progression.​

How to Manage Rectal Prolapse at Home

For mild to moderate cases, certain home management techniques can help control symptoms and slow progression:

• Eat a diet that promotes soft bowel movements: High-fiber foods combined with plenty of water reduce straining.

• Use a footstool in the bathroom: Elevating feet improves toilet posture making bowel movements easier.

• Try pelvic floor physical therapy: Professional guidance helps strengthen muscles correctly.

• Practice ‘reverse’ Kegels: Learning to relax pelvic muscles counters excessive tension caused by regular Kegels.

• Consider the ‘splinting’ strategy at bathroom time: Using fingers to support prolapsed tissue during bowel movements.

• Try the ‘moo to poo’ breathing method: Coordinating abdominal pressure with relaxed breathing eases strain.

These approaches help maintain muscle function and avoid aggravating the prolapse. Physical therapists specializing in pelvic health can tailor exercises and provide valuable education.​​

What to Do If Your Prolapse Is More Serious

If symptoms worsen—such as increased protrusion, bleeding, severe pain, or incontinence—medical intervention is necessary. Treatment options include:

• Manual reduction by a healthcare provider or guided self-reduction at home

• Barrier creams to protect irritated skin around the anus

• Surgical options like rectopexy or perineal resection, which restore normal anatomy and muscle function with high success rates

Surgery is generally reserved for severe prolapse or when conservative management fails. It is highly effective with techniques improving continence and quality of life in up to 97% of cases. Early surgical consultation prevents complications and recurrent prolapse.​

The Bottom Line on Rectal Prolapse

Rectal prolapse is a manageable condition when recognized early and addressed promptly. Women over 50 should never ignore symptoms such as anal bulging, discomfort, or bowel control issues. A combination of lifestyle adjustments, pelvic floor therapy, and medical treatment offers a path to symptom relief and restored confidence. While the condition can be distressing, professional support coupled with informed patient care ensures a positive outcome. Regular check-ups, awareness of bowel habits, and strengthening pelvic health remain essential in maintaining well-being well into midlife and beyond.