Rectal prolapse

Rectal prolapse is a condition where layers of the rectal wall protrude through the anal canal (beyond the anal verge).

• the condition has been described in Ebers Papyrus as early as 1500 bc.
• the rectal wall prolapse which does not protrude through the anus is known as internal rectal prolapse or rectal intussusception (1,2,3)

Rectal prolapse can be divided into:

• partial/mucosal - only the mucosa and submucosa protrude
• complete/full thickness/procidentia - full-thickness protrusion of all layers of rectum through the anal canal into the external environment (1,2)

Annual incidence of the condition is around 2.5 per 100,000 individuals.

• occurs in two main groups
  • the elderly
    • it is commonly seen among adults ages 50 to 89years
      • an epidemiological study reported that 87% of patients were older than 50 years
    • women are 6 times more likely to develop rectal prolapse after the age of 50 years
    • men with rectal prolapse tend to be younger e.g - younger than 40 years
  • infants and children
    • occurs typically before the age of 3 years
    • majority occurs during the first year of life
    • females and males are affected equally
    • prolapse is usually mucosal (1)

Reference:

• (1) American Academy of Family physicians (AAFP). FP Comprehensive 2016 - Board Preparation. Anorectal conditions. Rectal prolapse
• (2) O’Brien DP. Rectal Prolapse. Clinics in Colon and Rectal Surgery. 2007;20(2):125-132
• (3) Jones OM, Cunningham C, Lindsey I. The assessment and management of rectal prolapse, rectal intussusception, rectocoele, and enterocoele in adults. BMJ. 2011;342:c7099.