Rectal Prolapse

What is rectal prolapse?

The rectum is the lower part of the colon, or large intestine, before the anus. The primary job of the rectum is to hold stool. Rectal prolapse occurs when all or part of the rectal wall protrudes (or sticks out) from the anus. This often occurs while having a bowel movement, particularly when straining. Rectal prolapse often appears as a painless dark red mass, sometimes with a small amount of bleeding. 

What causes rectal prolapse?

Rectal prolapse most often occurs in younger children less than four years of age. In most children, rectal prolapse is due to an underlying condition. The most common predisposing condition in children is chronic constipation. When young children are constipated, particularly when toilet training, they often strain to help pass a bowel movement. This repeated straining leads to increased pressure inside the child’s belly and can lead to rectal prolapse. 

Other conditions that increase pressure in a child’s abdomen also can result in rectal prolapse, such as repeated vomiting or diarrhea (from a stomach bug) or chronic cough. Cystic fibrosis, polyps, neurologic disorders, or trauma are all rare causes of rectal prolapse. 

What should I do if my child has rectal prolapse?

In many instances, rectal prolapse will resolve on its own. If the prolapse does not resolve on its own, you should seek medical attention to have the prolapse corrected. If the rectal tissue is left prolapsed for an extended period of time, it can become painful and lead to ulceration, bleeding, and injury to the intestine. 

After the prolapse has resolved, it is important to follow up with your healthcare provider to determine the possible underlying cause. A thorough history and physical exam will be conducted to evaluate your child. If there is concern for underlying constipation, your child may be started on a laxative, as well as changes to their diet and behavior. If a rarer cause is suspected, further testing may be needed. 

Author: Peter Costa, MD
Editor: Riha Bhatt, MD
July 2025