clinical features
Last reviewed 01/2018
The patient complains of a variable length of 'something' coming down their back passage
- initially occurs during defecation or while straining but reduces spontaneously
- with time the condition becomes chronic and needs manual reduction
- the patient may find it impossible to get outside the house and may become socially isolated.
- often associated with mucous drainage and bleeding (1,2)
Patients often complain of a persisting dull perianal pain.
- in cases of strangulation, there is severe pain associated with constitutional symptoms, such as fever, chills, diaphoresis, nausea, and vomiting (1,2).
One-half to three-fourths of patients with rectal prolapse will experience fecal incontinence with a predominant problem of control of flatus or stools. It can be
- passive - manifests as leakage of which the patient is often initially unaware
- urge - when a patient becomes aware of the need to open their bowels but cannot get to the toilet in time (1,2).
Up to two-thirds of patients may also complain about constipation. This is thought to be caused by bowel dysmotility and pelvic floor dyssynergia (1)
In addition
- majority of patients also have urinary incontinence
- multiple pelvic organ prolapse in females e.g. - uterovaginal prolapse or cystocele .
Reference:
- (1) Jones OM, Cunningham C, Lindsey I. The assessment and management of rectal prolapse, rectal intussusception, rectocoele, and enterocoele in adults. BMJ. 2011;342:c7099.
- (2) American Academy of Family physicians (AAFP). FP Comprehensive 2016 - Board Preparation. Anorectal conditions. Rectal prolapse