Rectal Prolapse Care in Grand Rapids, Michigan

Rectal prolapse is a condition where the rectum (the last 15–20 cm of the large intestine) turns inside out and protrudes through the anus. It can be uncomfortable, embarrassing, and, without proper treatment, may worsen over time.

Residents in Grand Rapids, MI, who notice symptoms of rectal prolapse should seek prompt evaluation with a primary care provider, gastroenterologist, or colorectal surgeon at local health systems such as Spectrum Health, Trinity Health Grand Rapids, Metro Health, or Mercy Health.

What Is Rectal Prolapse?

The rectum normally acts as a temporary storage area for stool before a bowel movement. In rectal prolapse, the rectum loses its normal support and slips downward:

  • At first, it may only protrude during a bowel movement and then slide back in on its own.
  • Over time, it may remain outside and need to be pushed back manually.
  • In severe cases, it may stay out permanently and become painful or damaged.

Women are about six times more likely than men to develop rectal prolapse. Children under age three of any sex can also be affected; in many young children, the condition improves with conservative care and does not require surgery.

Symptoms of Rectal Prolapse

Symptoms can range from mild discomfort to severe functional problems. Common signs and symptoms include:

  • A visible bulge or protrusion from the anus, especially during or after a bowel movement
  • Pain or pressure deep in the lower abdomen or rectum
  • A feeling of incomplete emptying after a bowel movement
  • Difficulty passing stool or needing to strain
  • Blood or mucus from the anus
  • Leakage of liquid stool or mucus (fecal incontinence)
  • Needing large amounts of toilet paper to clean after a bowel movement

If you experience rectal bleeding, new incontinence, or a persistent bulge, schedule an evaluation. In Grand Rapids, you can start with your primary care provider or a colorectal specialist at Spectrum Health or Trinity Health Grand Rapids. The Kent County Health Department and Grand Rapids Public Health can also help connect uninsured or underinsured residents with appropriate care.

Types of Rectal Prolapse

Rectal prolapse is classified according to how much of the rectum is involved:

Internal Prolapse (Incomplete Prolapse)

  • The rectum folds in on itself but does not protrude through the anus.
  • Symptoms may mimic chronic constipation or obstructed defecation.

External Prolapse (Complete or Full-Thickness Prolapse)

  • The entire thickness of the rectal wall protrudes through the anus.
  • This is the classic form of rectal prolapse most people notice visually.

Mucosal Prolapse

  • Only the inner lining (mucosa) of the rectum protrudes through the anus.
  • This may be treated with less invasive procedures such as rubber banding in some cases.

Causes and Risk Factors

The exact cause of rectal prolapse is not fully understood, but several factors increase risk:

  • Chronic constipation and straining (very common in colder months in Michigan when people may drink less water and be less active)
  • Weakened pelvic floor muscles (often after pregnancy, childbirth, or aging)
  • Weakened anal sphincter muscles
  • Aging – more common in adults over 65
  • Genetic susceptibility – family history of rectal or pelvic organ prolapse
  • Chronic conditions that increase abdominal pressure, such as:
    • Chronic obstructive pulmonary disease (COPD)
    • Benign prostatic hypertrophy (enlarged prostate)
    • Chronic cough
  • Structural problems with the ligaments and tissues that support the rectum
  • Congenital bowel problems (e.g., Hirschsprung’s disease, neuronal intestinal dysplasia)
  • Prior trauma to the lower back or pelvis
  • Parasitic infections (such as schistosomiasis) – extremely rare in the United States, including West Michigan

In children, rectal prolapse may be linked to underlying conditions such as cystic fibrosis. About 11% of children with rectal prolapse have cystic fibrosis, so testing is often recommended.

Complications of Rectal Prolapse

Without proper treatment, rectal prolapse can lead to serious complications:

  • Ulceration and bleeding of the exposed rectal tissue
  • Incarceration – the prolapsed rectum cannot be pushed back inside
  • Strangulation – reduced blood supply to the rectum
  • Tissue death (gangrene) of the strangulated section of rectum

These complications are medical emergencies. If you or a family member in Grand Rapids experiences severe pain, a dark or discolored prolapsed rectum, or an inability to push the rectum back in, go immediately to an emergency department such as Spectrum Health Butterworth Hospital or Trinity Health Grand Rapids Hospital.

How Rectal Prolapse Is Diagnosed

Clinical Examination

A healthcare provider will:

  • Take a detailed medical history, including bowel habits and symptoms
  • Perform a physical exam and rectal exam
  • Sometimes ask you to bear down (as if having a bowel movement) during the exam to demonstrate the prolapse

If the rectum slides back in on its own, you may need to reproduce symptoms during the visit.

Additional Tests

To confirm the diagnosis and rule out other conditions (such as colorectal cancer), your provider may order:

  • Ultrasound of the pelvic floor
  • Specialized X-rays (defecography) to see how the rectum behaves during a bowel movement
  • Anorectal manometry to measure the strength and function of the anal and rectal muscles
  • Colonoscopy or sigmoidoscopy if there is rectal bleeding or concern for polyps or cancer

Pediatric patients in Grand Rapids with rectal prolapse may also be tested for cystic fibrosis and other underlying conditions at local children’s centers within Spectrum Health or Metro Health.

Treatment Options for Rectal Prolapse in Grand Rapids

Treatment depends on:

  • Age
  • Severity and type of prolapse
  • Presence of other pelvic organ prolapse (e.g., bladder prolapse)
  • Overall health and surgical risk

Non-Surgical Treatment

Non-surgical approaches are often first-line, especially in children or in mild cases:

1. Diet and Lifestyle Changes

The goal is to reduce constipation and straining:

  • High-fiber diet:
    • More fruits and vegetables
    • Wholegrain breads and cereals
    • Legumes (beans, lentils)
  • Adequate fluid intake – aim for plenty of water daily, especially during dry, heated indoor winters in Grand Rapids
  • Regular physical activity – walking, light exercise, and staying active, even in colder months
  • Avoid straining on the toilet – do not sit for long periods trying to pass stool

Your provider may recommend:

  • Fiber supplements (e.g., psyllium)
  • Stool softeners or mild laxatives if diet alone is not enough

For many young children in West Michigan, these measures alone are enough to resolve rectal prolapse.

2. Pelvic Floor Therapy

In adults, especially women with weakened pelvic floor muscles:

  • Pelvic floor physical therapy can strengthen muscles that support the rectum and improve bowel control.
  • Several physical therapy practices in Grand Rapids specialize in pelvic floor rehabilitation and can be accessed with a referral from your local provider.

3. Office Procedures for Mucosal Prolapse

In some cases of mucosal prolapse:

  • Rubber band ligation (banding) can be used to secure the prolapsed mucosa and promote scarring that holds tissue in place.

Surgical Treatment for Rectal Prolapse

Surgery is usually recommended for:

  • Full-thickness (complete) rectal prolapse
  • Symptomatic internal prolapse that does not improve with conservative care
  • Recurrent or severe prolapse affecting quality of life

Colorectal surgeons in Grand Rapids at Spectrum Health, Trinity Health Grand Rapids, Metro Health, and Mercy Health commonly perform these procedures.

Before Surgery

In the days leading up to surgery, you can expect:

  • Pre-operative evaluation – review of your medical history, medications, and tests
  • Bowel preparation – you may be asked to drink a special solution to cleanse the bowel
  • Fasting from food and certain liquids before surgery
  • A visit from the anesthesiologist to determine the safest type of anesthesia
  • Possible pre-medication to help you relax and prepare for anesthesia

Types of Rectal Prolapse Surgery

1. Abdominal Surgery (Rectopexy)

Performed either as:

  • Laparotomy (open abdominal surgery) – one larger incision in the abdomen
  • Laparoscopy (keyhole or minimally invasive surgery) – several small incisions with a camera and instruments

Procedure typically involves:

  • Gently moving aside abdominal organs
  • Lifting and straightening the rectum
  • Tethering (fixing) the rectum to the sacrum (the central bone of the pelvis) with sutures or mesh
  • Sometimes removing a short segment of bowel if there is redundancy or severe constipation

Advantages of laparoscopy:

  • Smaller incisions
  • Reduced pain
  • Faster recovery time compared with open surgery

Abdominal approaches often provide better long-term results and lower recurrence rates, particularly in younger and healthier patients.

2. Anal (Perineal) Surgery

Often chosen for:

  • Older adults
  • Patients with significant medical conditions who may not tolerate abdominal surgery well

Under anesthesia, the surgeon:

  • Gently pulls the prolapsed rectum out through the anus
  • Removes the prolapsed section of bowel
  • Repairs damaged structures
  • Rejoins the healthy ends of the bowel and returns them inside

Perineal procedures are generally less stressful on the body and may have a shorter hospital stay, but sometimes have higher recurrence rates than abdominal procedures.

Immediately After Surgery

After rectal prolapse surgery at a Grand Rapids hospital, you can expect:

  • Monitoring of temperature, pulse, breathing, and blood pressure
  • An intravenous (IV) line to provide fluids and medications
  • Pain-relieving medications – inform your nurse if your pain is not well controlled
  • Possibly a urinary catheter for a day or two until you can urinate on your own
  • In some cases, a vaginal pack (for women who had associated rectocele repair), which is removed later the same day or the next day

Hospital stay typically ranges from 3 to 6 days, depending on the type of surgery and your overall health.

Possible Complications of Surgery

While most rectal prolapse surgeries are successful, potential complications include:

  • Recurrence of rectal prolapse
  • Allergic reaction to anesthesia
  • Bleeding (hemorrhage)
  • Infection at the incision or within the pelvis
  • Injury to nearby nerves or blood vessels
  • Damage to other pelvic organs, such as the bladder or vagina
  • Death (necrosis) of the rectal wall if blood supply is compromised

Discuss your individual risks with your colorectal surgeon. Grand Rapids hospitals follow strict infection control and surgical safety protocols, but all surgery carries some risk.

Recovery at Home in Grand Rapids

Follow your surgeon’s discharge instructions carefully. General recommendations often include:

  • Rest as much as possible in the first few weeks
  • Avoid heavy lifting or straining (including lifting children, heavy groceries, or snow shoveling in winter)
  • Do not strain on the toilet – use stool softeners or fiber supplements as directed
  • Maintain a high-fiber diet and drink plenty of water to prevent constipation
  • Walk short distances frequently to promote circulation and healing

Women who have had rectocele repair may experience bloody vaginal discharge for about four weeks; this is usually normal. Contact your doctor if you notice:

  • Difficulty urinating or inability to pass urine
  • Heavy or persistent bleeding
  • Fever or chills
  • Increasing pain or swelling
  • Redness, warmth, or drainage from incision sites

Most people can return to work in about six weeks, depending on the type of work and the extent of surgery.

Long-Term Outlook

  • Surgery provides good results in most cases of rectal prolapse.
  • Some patients may continue to have constipation or a feeling of incomplete emptying and may need ongoing bowel management and pelvic floor therapy.
  • Rectocele (a bulge of the rectum into the vagina) may recur in about 10% of women after surgery.

Long-term success is improved by:

  • Maintaining a high-fiber diet
  • Staying well-hydrated, especially during dry indoor heating seasons in West Michigan
  • Staying physically active year-round (indoor walking tracks, malls, or community centers can help in winter)
  • Avoiding chronic straining and heavy lifting

Attend all follow-up appointments with your surgeon or gastroenterologist to monitor healing and address any ongoing symptoms.

Rectal Prolapse in Children

In children, especially those under age three:

  • Rectal prolapse is relatively common and often resolves with conservative measures.
  • Treatment focuses on:
    • Correcting constipation
    • Ensuring adequate nutrition and hydration
    • Treating any underlying condition (such as cystic fibrosis)

Pediatric specialists in Grand Rapids (through Spectrum Health or Metro Health) can guide families on evaluation and treatment.

Local Resources in Grand Rapids, MI

If you suspect rectal prolapse or have concerning bowel symptoms, consider the following local options:

  • Primary Care Providers – first step for evaluation and referral
  • Colorectal and General Surgeons – available through:
    • Spectrum Health
    • Trinity Health Grand Rapids
    • Metro Health – University of Michigan Health
    • Mercy Health
  • Kent County Health Department / Grand Rapids Public Health – assistance with finding care, especially for uninsured or underinsured residents
  • Pelvic Floor Physical Therapy Clinics – for non-surgical management and post-surgical rehabilitation

Key Points to Remember

  • Without treatment, rectal prolapse can worsen and may eventually require manual repositioning or emergency care.
  • Prevent constipation with a high-fiber diet, plenty of water, and regular physical activity – this is especially important during long, cold Michigan winters.
  • Surgery is often needed for moderate to severe prolapse, and can be performed through the abdomen (open or laparoscopic) or via the anus, depending on your health and the surgeon’s recommendation.
  • With proper treatment and lifestyle changes, most people in Grand Rapids with rectal prolapse can return to normal daily activities and significantly improve their quality of life.