aetiology
Last reviewed 01/2018
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
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