Rectal Prolapse HF#5980

A rectal prolapse is when the rectum comes down from its normal place because the support structures and muscles of the pelvis and anus are weak.  Straining during bowel movements, childbirth, age, family history, and spinal cord disease can cause this problem.

 

A complete health history and rectal exam is needed to assess this problem.  Tests can help your doctor decide if surgery is right for you.

 

• X-rays may be done if the prolapse cannot be seen on exam.

 

• A special probe test (manometry) measures how well the anal muscles work.

 

Surgery

 

Your surgeon looks at your age, health, degree of the prolapse, test results, and the presence or absence of other prolapsed organs (such as your bladder) to decide if surgery can help you. 

 

The surgery to repair a rectal prolapse may be a rectopexy or a resection.  The prolapsed rectum is moved and attached to the inside of the pelvis or is taken out.  A section of the colon may also be taken out.  There are three ways this repair can be done: 

 

• Abdominal Approach:  One incision in your abdomen.  Hospital stay is 5 – 7 days.  Back to work in 4 – 6 weeks. 
• Laparoscopic Assisted Approach:  1 – 4 small incisions in your abdomen.  Hospital stay is 3 – 5 days.  Back to work in 2 – 3 weeks.
• Transanal Approach: the prolapse is repaired through the anal canal.  Hospital stay is 1 – 3 days.  Back to work in 2 – 3 weeks.

 

Home Care

 

Diet

 

You will start with a full liquid diet that will move to a low fiber diet.  Keep your stool soft so you do not strain during bowel movements.  You may need to take stool softeners.  Be sure to drink at least 8 – 10 (8 ounce) glasses of water a day.  Your doctor will tell you when you can go back to your normal diet.

 

Pain

 

The amount of pain you have depends on the extent of your repair and the size and location of your incision(s).  You will have pain pills to take at home.  Take them when you first feel the pain.  This will give you better pain control and can help you heal faster.

 

Activity

 

• Plan rest times during the day.  You will feel tired.
• Check with your doctor before going back to work. 
• Nothing more strenuous than walking until okayed by your doctor.
• Do not strain during bowel movements
• Do not lift more than 20 pounds for 4 – 6 weeks
• No sexual activity until okayed by your surgeon
• No driving for 3 – 4 weeks and as long as you are taking narcotic pain pills

 

Incision Care

 

• Wear loose clothes.
• Two days after surgery you may shower and gently wash your incisions with mild soap and water.  Do not soak in a hot tub, bathtub, or go swimming until your incisions heal, this may be 2 weeks or longer.  Do not put lotion, ointment, or powder on your incisions.  You may wear Band-Aids if you wish, remember to change them every day to prevent infection.
• Small areas of bruising at your incision site are expected.
• Check your incision daily for signs of infection:
  • Increased redness, swelling or warmth
  • Drainage such as blood or pus
  • Temperature over 100.4° F by mouth for two readings taken 4 hours apart

 

Follow up

 

You will see your surgeon 1 – 2 weeks after your repair.

 

When to Call the Doctor 

 

• Temperature over 100.4 °F (by mouth) for two readings taken 4 hours apart
• Painful bloating or cramping
• Increased redness at the incision site or warm to the touch
• Pus or excess bleeding from the incision
• Pain not controlled by pain pills
• Return of the rectal prolapse
• Unable to have a bowel movement
• Unable to control bowel movements

 

Phone Numbers

 

Digestive Health Center: (608) 890-5000.

 

After hours, weekends or holidays this number will be answered by the paging operator.  Ask for the doctor on call or ask for Dr. Harms, Heise, Kennedy, or Foley.  Leave your name and phone number with area code. The doctor will call you back.

 

If you live out of the area, call (855) 342-9900.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 04/24/2013

Copyright © 09/23/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5980

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