eMedicine Specialties > Emergency Medicine > Gastrointestinal

Rectal Prolapse: Treatment & Medication

Author: Lynn K Flowers, MD, MHA, FACEP, Physician Partner, ApolloMD, Atlanta, Georgia
Contributor Information and Disclosures

Updated: Nov 5, 2009

Treatment

Emergency Department Care

  • Generally, a prolapsed rectum can be reduced with gentle digital pressure. Sedation and local perianal anesthesia may aid in the reduction.
  • Significant bowel edema may make manual reduction difficult. The topical application of granulated sucrose to the mucosal surface may reduce bowel edema and allow reduction.
  • Contributing factors, such as constipation and diarrhea, should be addressed and eliminated if possible.
  • Supportive care should be provided according to the clinical picture, particularly in the presence of an irreducible prolapse and with gangrene or rupture of the rectal mucosa.

Consultations

  • Obtain a prompt surgical consultation with a general surgeon or a colorectal surgeon for an irreducible prolapse and for strangulation or gangrene of the prolapsed tissue.
  • In cases of uncomplicated rectal prolapse, arrange surgical follow-up care for further evaluation and definitive treatment.

More on Rectal Prolapse

Overview: Rectal Prolapse
Differential Diagnoses & Workup: Rectal Prolapse
Treatment & Medication: Rectal Prolapse
Follow-up: Rectal Prolapse
Multimedia: Rectal Prolapse
References

References

  1. Gourgiotis S, Baratsis S. Rectal prolapse. Int J Colorectal Dis. Mar 2007;22(3):231-43. [Medline].

  2. Kairaluoma MV, Kellokumpu IH. Epidemiologic aspects of complete rectal prolapse. Scand J Surg. 2005;94(3):207-10. [Medline].

  3. Madiba TE, Baig MK, Wexner SD. Surgical management of rectal prolapse. Arch Surg. Jan 2005;140(1):63-73. [Medline].

  4. Marderstein EL, Delaney CP. Surgical management of rectal prolapse. Nat Clin Pract Gastroenterol Hepatol. Oct 2007;4(10):552-61. [Medline].

  5. Abcarian H. Prolapse and procidentia. In: Zuidema GD, ed. Shackelford's Surgery of the Alimentary Tract. 4th ed. WB Saunders Co; 1996:368-85.

  6. Bartolo DC. Rectal prolapse. Br J Surg. Jan 1996;83(1):3-5. [Medline].

  7. Boccasanta P, Rosati R, Venturi M, Montorsi M, Cioffi U, De Simone M, et al. Comparison of laparoscopic rectopexy with open technique in the treatment of complete rectal prolapse: clinical and functional results. Surg Laparosc Endosc. Dec 1998;8(6):460-5. [Medline].

  8. Coburn WM 3rd, Russell MA, Hofstetter WL. Sucrose as an aid to manual reduction of incarcerated rectal prolapse. Ann Emerg Med. Sep 1997;30(3):347-9. [Medline].

  9. Demirbas S, Ogün I, Celenk T, Akin ML, Erenoglu C, Yldz M. Early outcomes of laparoscopic procedures performed on military personnel with total rectal prolapse and follow-up. Surg Laparosc Endosc Percutan Tech. Aug 2004;14(4):194-200. [Medline].

  10. Fengler SA, Pearl RK, Prasad ML, Orsay CP, Cintron JR, Hambrick E, et al. Management of recurrent rectal prolapse. Dis Colon Rectum. Jul 1997;40(7):832-4. [Medline].

  11. Heine JA, Wong WD. Rectal prolapse. In: Mazier WP, ed. Surgery of the Colon, Rectum, and Anus. Harcourt Brace & Co; 1995:515-33.

  12. Hull TL, Milsom JW. Pelvic floor disorders. Surg Clin North Am. Dec 1994;74(6):1399-413. [Medline].

  13. Jacobs LK, Lin YJ, Orkin BA. The best operation for rectal prolapse. Surg Clin North Am. Feb 1997;77(1):49-70. [Medline].

  14. Siafakas C, Vottler TP, Andersen JM. Rectal prolapse in pediatrics. Clin Pediatr (Phila). Feb 1999;38(2):63-72. [Medline].

  15. Williams JG, Madoff RD. Perineal repair for rectal prolapse. In: Problems in General Surgery. Vol 9. 1992:732-8.

Further Reading

Keywords

rectal prolapse, rectal prolapse symptoms, rectal prolapse causes, rectal prolapse treatment, constipation, rectal pain, rectal bleeding, rectal ulceration, prolapsed rectum, fecal incontinence

Contributor Information and Disclosures

Author

Lynn K Flowers, MD, MHA, FACEP, Physician Partner, ApolloMD, Atlanta, Georgia
Lynn K Flowers, MD, MHA, FACEP is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, National Association of EMS Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

Michael S Beeson, MD, MBA, FACEP, Professor of Emergency Medicine, Northeastern Ohio Universities College of Medicine and Pharmacy; Attending Faculty, Summa Health System
Michael S Beeson, MD, MBA, FACEP is a member of the following medical societies: American College of Emergency Physicians, Council of Emergency Medicine Residency Directors, National Association of EMS Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Eugene Hardin, MD, FAAEM, FACEP, Former Chair and Associate Professor, Department of Emergency Medicine, Charles Drew University of Medicine and Science; Former Chair, Department of Emergency Medicine, Martin Luther King Jr/Drew Medical Center
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Jonathan Adler, MD, Attending Physician, Department of Emergency Medicine, Massachusetts General Hospital; Division of Emergency Medicine, Harvard Medical School
Jonathan Adler, MD is a member of the following medical societies: American Academy of Emergency Medicine and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

 
 
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