Rectal Prolapse: Understanding Your Condition and Treatment Options

Overview

Rectal prolapse is a condition where part or all of the rectum slips outside the anal opening, creating a visible protrusion that can significantly impact daily life and bowel function. While this condition can feel overwhelming to experience or discuss, effective treatment options are available to help you regain comfort and confidence in your daily activities.

This condition affects approximately 2.5 per 100,000 people annually, with a notable pattern in who experiences it most frequently. Rectal prolapse is six times more common in women than men, particularly affecting individuals over age 50. Women who have experienced vaginal childbirth, those with a history of chronic constipation, and people with connective tissue disorders may be at higher risk. However, rectal prolapse can occur across all age groups and genders, including children and young adults, especially those with certain medical conditions or chronic straining patterns.

The good news is that pelvic floor physical therapy plays a vital role in both managing rectal prolapse symptoms and supporting recovery after surgical treatment. At Mendwell Pelvic Health, our specialized approach focuses on strengthening your pelvic floor muscles, improving coordination, and addressing the underlying factors that contribute to this condition. Whether you're seeking conservative management or post-surgical rehabilitation, pelvic health therapy can help improve your symptoms and enhance your quality of life.

Symptoms

Recognizing the symptoms of rectal prolapse is important for seeking appropriate care. Many people initially notice subtle changes that gradually become more pronounced over time.

Visible and Physical Symptoms:

• A reddish or pink tissue mass protruding from the anus, especially noticeable during bowel movements or physical activity
• Feeling of pressure, fullness, or heaviness in the rectal area
• Sensation that something is "falling out" or protruding
• Visible tissue that may need to be manually pushed back inside

Bowel Function Changes:

• Difficulty controlling bowel movements or unexpected leakage (fecal incontinence)
• Chronic constipation or straining during bowel movements
• Feeling of incomplete bowel evacuation, even after using the bathroom
• Changes in stool consistency or frequency
• Difficulty completely emptying the bowels

Comfort and Daily Life Impact:

• Mucus discharge or bleeding from the protruding tissue
• Anal discomfort, pain, or irritation that may worsen with sitting or physical activity
• Increased awareness of pelvic floor muscles during movement
• Impact on exercise, work activities, or intimate relationships
• Anxiety or embarrassment related to symptoms

Causes

Understanding what contributes to rectal prolapse can help in both treatment and prevention strategies. Multiple factors often work together to weaken the support structures of the rectum.

Pelvic Floor and Muscle Factors: The pelvic floor muscles and connective tissues that support your pelvic organs can weaken over time or due to specific stressors. Chronic straining during bowel movements puts excessive pressure on these support structures. Pregnancy and childbirth, particularly vaginal delivery, can stretch and weaken the pelvic floor muscles and surrounding tissues. Previous pelvic surgeries or trauma may also compromise the structural support system.

Bowel Function and Digestive Factors: Chronic constipation creates a cycle where increased straining weakens pelvic support over time. Conversely, chronic diarrhea can also contribute by causing frequent urgency and straining. Conditions that affect normal bowel function, such as irritable bowel syndrome or inflammatory bowel disease, may increase risk when combined with other factors.

Lifestyle and Physical Factors: Certain activities and lifestyle patterns can increase abdominal pressure and stress the pelvic floor. Heavy lifting, high-impact exercise without proper form, or jobs requiring prolonged sitting or standing may contribute. Obesity increases intra-abdominal pressure, while smoking can weaken connective tissues and increase coughing, which adds pressure to the pelvic floor.

Age-Related and Hormonal Changes: As we age, the connective tissues that support our pelvic organs naturally weaken. Nerve function may change, affecting muscle coordination and sensation. Hormonal changes, particularly during menopause, can affect tissue strength and elasticity. These changes don't guarantee rectal prolapse will develop, but they can increase susceptibility when combined with other risk factors.

How Pelvic Floor Physical Therapy Can Help

Pelvic floor physical therapy offers comprehensive support for individuals with rectal prolapse, whether you're pursuing conservative management or recovering from surgery. Our evidence-based approach addresses both symptoms and underlying contributing factors.

Conservative Management and Prevention: For many people with mild to moderate rectal prolapse, pelvic floor physical therapy can significantly improve symptoms and may help prevent progression. We focus on strengthening your pelvic floor muscles through targeted exercises that improve both strength and coordination. You'll learn proper techniques for bowel movements that reduce straining and pressure on your pelvic floor. Our therapists teach breathing techniques and core coordination exercises that support your pelvic organs during daily activities.

Education plays a crucial role in conservative management. We help you understand your condition and identify lifestyle modifications that can reduce symptoms. This includes guidance on proper toileting positions, timing, and techniques that promote healthy bowel function without excessive straining.

Post-Surgical Rehabilitation and Support: If you've had or are planning rectal prolapse surgery, pelvic floor physical therapy is essential for optimal recovery. We provide guided rehabilitation that helps you safely return to normal activities while protecting your surgical repair. Our progressive exercise programs are designed to restore strength and function without compromising healing.

Post-surgical care includes scar tissue management techniques when appropriate, helping to maintain tissue flexibility and reduce adhesions. We also focus on preventing recurrence by addressing the factors that contributed to the original prolapse.

Comprehensive Symptom Management: Our treatment approach addresses the full spectrum of rectal prolapse symptoms. For bowel function concerns, we teach techniques to improve evacuation efficiency and reduce incomplete emptying sensations. Manual therapy techniques, when appropriate, can help address muscle tension and improve tissue mobility around the pelvic area.

We also provide strategies for managing the emotional and psychological aspects of living with rectal prolapse, including techniques for maintaining confidence in social and intimate situations.

Treatment Methods You Can Expect:

At Mendwell Pelvic Health, your treatment plan will be completely individualized based on your specific symptoms, goals, and lifestyle needs. During your initial evaluation, we conduct a thorough assessment of your pelvic floor muscle function, bowel habits, and the impact of symptoms on your daily life.

Your treatment may include specialized pelvic floor muscle training using techniques like biofeedback to help you better understand and control these muscles. We incorporate functional movement training that teaches you how to protect your pelvic floor during daily activities. Manual therapy techniques may be used to address muscle tension or restrictions that contribute to your symptoms.

Education and self-management strategies are central to our approach. You'll receive detailed guidance on bowel health optimization, including dietary considerations and timing strategies. We also provide home exercise programs that you can easily integrate into your daily routine.

Frequently Asked Questions

Can pelvic floor physical therapy cure my rectal prolapse without surgery?

While pelvic floor physical therapy can significantly improve symptoms and may prevent progression in mild cases, the potential for complete resolution without surgery depends on several factors including the severity of your prolapse and contributing factors. Many people experience substantial symptom relief through conservative management. Your pelvic health therapist will work closely with your healthcare team to monitor your progress and help determine the most appropriate treatment path for your specific situation.

What should I expect during my first pelvic floor therapy appointment for rectal prolapse?

Your initial appointment will include a comprehensive discussion of your symptoms, bowel habits, medical history, and how rectal prolapse affects your daily life. Your therapist will explain the condition and treatment options in detail. The physical examination may include an assessment of your pelvic floor muscle function, posture, and movement patterns. You'll leave with a clear understanding of your treatment plan and initial strategies you can begin using immediately.

How long does pelvic floor physical therapy take to help with rectal prolapse symptoms?

Many people begin noticing improvements in symptoms within 4-6 weeks of consistent treatment, though individual timelines vary based on factors like symptom severity, adherence to home exercises, and overall health. Some improvements, like better bowel habits and reduced straining, may be noticed sooner. Your therapist will discuss realistic expectations and timeline goals during your evaluation and adjust them as you progress through treatment.

Is it safe to exercise and stay active with rectal prolapse?

With proper guidance, most people with rectal prolapse can safely maintain an active lifestyle. Your pelvic floor physical therapist will help you modify activities to avoid excessive straining while maintaining fitness and strength. Low-impact exercises like walking, swimming, and modified strength training are often well-tolerated. High-impact activities or heavy lifting may need to be modified or avoided depending on your condition severity.

Will my insurance cover pelvic floor physical therapy for rectal prolapse treatment?

Most insurance plans cover pelvic floor physical therapy when prescribed by a physician for conditions like rectal prolapse. Coverage varies by plan, so we recommend checking with your insurance provider about your specific benefits. Our team can help verify your coverage and work with you to understand any out-of-pocket costs before beginning treatment.

Can rectal prolapse come back after successful treatment?

While rectal prolapse can recur, following your pelvic floor physical therapy program significantly reduces this risk. Continuing with prescribed exercises, maintaining healthy bowel habits, and staying aware of factors that can increase pelvic floor pressure all help prevent recurrence. Your therapist will provide you with long-term management strategies and warning signs to watch for, ensuring you have the tools to maintain your progress over time.