Internal rectal prolapse

Internal rectal prolapse (IRP) is a medical condition in which the wall of the rectum folds in on itself in a telescopic, funnel-shaped way during defecation. The name is used when the prolapsed section stays inside the body and cannot be seen from outside. It is one of three main types of rectal prolapse, the others being external rectal prolapse, where the segment protrudes through the anus, and rectal mucosal prolapse, where only the mucosal layer prolapses. IRP may cause no symptoms, or it may cause obstructed defecation syndrome and fecal incontinence. The causes are not clear. It may be the first stage of a progressive condition that ends in external prolapse, although that progression is uncommon, and chronic straining at stool, connective tissue disorders and anatomic factors such as a loose attachment of the rectum to the sacrum, a redundant sigmoid colon or a deep pouch of Douglas may be involved. IRP is often found alongside rectocele, enterocele or solitary rectal ulcer syndrome. It usually affects females who have given birth at least once, about 10 percent of cases are in males, and more severe forms are linked with older age. Severity is graded on defecography, for example by the Oxford rectal prolapse grade, which runs from grade I to grade V for overt external prolapse. When symptoms need treatment it is by non-surgical measures such as biofeedback or by surgery, most often ventral rectopexy. This entry records what is held about the condition and is not medical advice.