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Aetiology

Authoring team

Multiple factors act as predisposing factors for rectal prolapse.

Infants and children

  • anatomical/structural abnormalities
    • absent Houston valves (seen in 75% of prolapse in children <1 year)
    • anorectal hypotonia
    • low position of the rectum
    • megacolon (Hirschsprung disease)
    • poor underlying tissue support for anal mucosa
    • redundant sigmoid colon
    • underdeveloped sacral curve leading to direct downward course of the rectum
  • functional causes
    • chronic straining associated with constipation
    • infectious disease
    • chronic diarrhoea
    • parasitic infestations (trichuriasis)
  • other
    • cystic fibrosis
    • malnutrition
    • neoplasm (polyps)
    • neurologic disorders (meningomyelocele)

Adults

  • anatomical/structural abnormalities
    • lack of or poor attachment of the rectum to the retrorectal tissues and sacrum
    • pelvic floor muscle weakness
    • prior pelvic surgery
  • neurologic disorders
    • cerebrovascular accident
    • dementia
    • pudendal neuropathy
  • other
    • multiparity
    • psychiatric disorders

Reference:

1. American Academy of Family physicians (AAFP). FP Comprehensive 2016 - Board Preparation. Anorectal conditions. Rectal prolapse

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