Rectal prolapse symptoms are often distressing – they can impact on quality of life and self esteem. These Physiotherapist techniques can help manage and provide relief from commonly experienced rectal prolapse symptoms including soiling, bulging, constipation and wetness.
Read on now for these rectal prolapse symptoms:
- Anal bulge
- Faecal incontinence and staining
- Rectal Pain
- Rectal bleeding
Help for Rectal Prolapse Symptoms
Rectal prolapse symptoms can be classified into two groups; symptoms associated directly with the rectal prolapse, and symptoms that develop indirectly as a result of associated difficulties with cleanliness and hygiene. The symptoms most commonly experienced with rectal prolapse usually become more noticeable as the prolapse worsens.
1. Anal Bulge or Protrusion
The main rectal prolapse symptom is a bulge or protrusion of red coloured tissue from the anus. It is common for this protrusion to become evident after a bowel movement, and in the initial stages the bulge may retract or draw back inside the anus upon standing.
In the case of more severe rectal prolapse, the rectal bulge becomes more apparent with heavy lifting, coughing or sneezing. In the most severe stages of rectal prolapse, the rectal protrusion is often evident during everyday activities such as standing and walking and doesn’t retract back inside the anus. When the rectal prolapse stays outside the rectum, this is a medical emergency and requires immediate medical assessment and treatment.
Tips to minimise rectal prolapse strain
- Avoid constipation and straining using good bowel emptying technique.
- Manage your body weight to minimise pressure on your prolapse.
- Strengthen your pelvic floor muscles with rectal prolapse exercises to support your prolapse.
- Use your pelvic floor muscles to brace against increased pressure caused by coughing or sneezing.
- Stay fit and strong with pelvic floor safe exercises for prolapse.
- Avoid compromising positions such as deep squats.
- Avoid heavy lifting and prolonged standing.
2. Faecal Incontinence and Staining
Rectal prolapse symptoms include faecal incontinence or involuntary loss of bowel contents. Incontinence of faeces may range from stained underwear and difficulty wiping clean, to loss of liquid and sometimes solid faeces. The rectal prolapse stretches and opens the anus, causing loss of faeces.
The protruding rectal tissue can be very difficult to clean after bowel movements. This problem can be socially embarrassing with the odour from unwanted leakage. Furthermore painful skin breakdown and risk of infection can increase around the anus with faecal incontinence.
Loss of mucous from the anus is also associated with rectal prolapse. It can be very difficult for those affected by rectal prolapse to clean and stay clean. The mucous secreting inner folds of the rectum become exposed externally with the rectal prolapse, causes a feeling of constant wetness with ongoing mucous discharge from the rectum.
Tips to minimise faecal incontinence and staining
- Keep your stool consistency soft and well formed – a loose stool is more likely to leak.
- Use the correct bowel emptying technique for complete emptying without straining.
- Alcohol–free moist wipes or towelettes can assist cleaning.
- Make your last wipe a moist one.
- Try to establish a good bowel habit routine to empty at a convenient time.
- Speak with your doctor about your suitability for using of a gentle suppository to empty any remaining bowel residue.
- Try to avoid bowel irritants such as caffeine and spicy foods.
- Use a barrier cream around the anus to protect skin against breakdown.
- A plain eye make-up removal pad can provide a barrier for odour and mucous leakage
Constipation is a frequently reported rectal prolapse symptom. Sometimes it is necessary for manual assistance using the fingers to help empty the bowels completely. A straining pattern of bowel emptying is often habitual with rectal prolapse. A feeling of incomplete emptying with the sense of contents still remaining in the rectum after moving the bowels can also accompany rectal prolapse.
Tips for managing constipation with a rectal prolapse
- Never ignore the urge to empty your bowels if constipated – go immediately upon sensing the urge to empty.
- Use an appropriate bowel emptying technique to help empty effectively and avoid straining.
- Allow yourself the quiet time to empty rather than rushing.
- Deep breathing can help to relax the anal sphincter muscles to allow emptying.
- Always have breakfast and a warm drink to stimulate your bowels.
- Ensure that your diet is well balanced with appropriate fibre intake – this is often trial and error for many individuals.
- Ensure your fluid intake is adequate.
- Perform regular pelvic floor exercises.
- Perform regular pelvic floor safe low-impact exercises.
- Use relaxation techniques such as deep breathing to help manage stress levels.
4. Rectal Pain
Rectal prolapse can be associated with a dull ache in the rectum, but not in all cases and this is a variable symptom from one individual to another. Pain can also occur with rectal ulceration which may be associated with rectal prolapse. Ulceration usually occurs on the front wall of the rectum, and can also be accompanied by rectal bleeding. Rectal pain must be investigated by a medical practitioner.
5. Rectal Bleeding
Bleeding of the lining of the rectum may be associated with rectal prolapse, but once again this is a variable symptom of rectal prolapse. Rectal bleeding can be symptomatic of other serious medical problems and needs to be investigated by a medical practitioner.
Important Information: If you experience any of the symptoms listed here, or if your suspect you may have a rectal prolapse, a thorough medical assessment is essential. If you have already undergone a thorough medical assessment, treatment from a trained Pelvic Floor Physiotherapist or Continence and Women’s Health Physiotherapist can assist your further management of rectal prolapse symptoms.
ABOUT THE AUTHOR, Michelle Kenway
Michelle Kenway is a Pelvic Floor Physiotherapist and author of Prolapse Exercises Inside Out. Prolapse Exercises is a complete exercise guide for women with prolapse and after prolapse surgery seeking to exercise safely and protect their pelvic floor.