Rectal Prolapse - Exams and Tests

Exams and Tests

A doctor can diagnose rectal prolapse by asking you questions about your symptoms and by doing a thorough physical exam. The doctor may ask questions about when your symptoms began and whether they have changed over time. Specifically, your doctor may ask whether you have had:

• Any bleeding or irritation around your anus.
• Leakage of mucus or stools that may stain underwear.
• Any tissue that slips out of your anus and when it occurs.

Also, your doctor may ask about any past surgeries or medical conditions, such as whether you have:

• Had rectal surgery.
• Had pelvic surgery, such as the removal of your uterus (hysterectomy).
• Had a back injury, surgery, or condition such as spina bifida.
• Given birth, how many times you have given birth, and whether you ever had complications, such as not being able to control your bladder or bowels after delivery (stress incontinence).
• Diseases such as celiac disease, cystic fibrosis, or inflammatory bowel disease.
• Used laxatives or enemas regularly or used other products to help with bowel movements.

The physical exam usually includes:

• Examining the rectum with a gloved finger to feel for loose tissue and to determine how strongly the anal sphincter contracts. You may be asked during the exam to strain as you would during a bowel movement. The doctor may observe the anus while you strain to test the strength of your pelvic muscles and to see whether tissue drops out of your anus.
• Inspecting the skin around the anus for irritation, which may indicate a discharge of mucus, contact with stools, or excessive cleaning.
• Testing the sensation around the anus with sharp and dull instruments to determine how well the nerves are working.

Other tests are often done to rule out other conditions that may be contributing to the problem. These tests may include:

• Anoscopy, sigmoidoscopy, colonoscopy, or a barium enema to look for growths such as tumors, sores (ulcers), or abnormally narrow areas in the large intestine.
• A fecal occult blood test to look for hidden (occult) blood in the stool.
• Defecography, which is a series of X-rays (like a motion picture) to evaluate the rectum and anal sphincter during a bowel movement.
• Anal manometry to measure the strength of the anal sphincter.
• Electromyography to determine whether there is a problem with the nerves that lead to the anal sphincter.
• Sweat test for cystic fibrosis in children who have unexplained or recurrent rectal prolapse.