Rectal prolapse in children

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Rectal prolapse in children

Rectal prolapse in children most commonly happens before the age of 4, and usually before age 1. Boys and girls are equally likely to develop the condition.

A child's risk of developing rectal prolapse may increase because of a structural problem in the digestive system. Other conditions that increase a child's risk for rectal prolapse include:

• Increased abdominal pressure. Rectal prolapse may develop in a child who frequently strains during bowel movements, such as from problems with long-term (chronic) constipation. Pressure from forceful coughing spells, such as those caused by whooping cough (pertussis) or long-term lung disease from cystic fibrosis, may also lead to rectal prolapse.
• Short-term or long-term diarrhea. Giardiasis or Escherichia coli (E. coli) infection may cause short-term diarrhea. Conditions that prevent proper food absorption, such as celiac disease or inflammatory bowel disease, may cause long-term diarrhea.
• Parasitic diseases. Parasites such as whipworms increase the risk of prolapse.
• Cystic fibrosis. This disease of the mucous glands is associated with conditions throughout the body, including digestive problems. About 20% of children with rectal prolapse will have cystic fibrosis.¹ A child who has rectal prolapse with no obvious cause may need to be tested for cystic fibrosis.
• Pelvic floor weakness. Weakness of these muscles, which stretch across the floor of the pelvis, may be associated with damage caused by nerve disorders or spinal cord deformities (such as spina bifida) or may develop after pelvic surgery.
• Malnutrition. Across the world, lack of proper nutrition may be the most common cause of rectal prolapse in children. This is especially true in underdeveloped countries. Malnutrition prevents children from developing supportive tissues around the rectum.
• Hirschsprung's disease. The birth defect Hirschsprung's disease affects muscular contractions of the bowel, which can lead to rectal prolapse.
• Not having an opening in the anus (imperforate anus). The surgery to repair an imperforate anus can make rectal prolapse more likely.

References

Citations

1. Gearhart SL, Bulkley G (2005). Common diseases of the colon and anorectum and mesenteric vascular insufficiency. In DL Kasper et al., eds., Harrison's Principles of Internal Medicine, 16th ed., vol. 2, pp. 1795–1803. New York: McGraw-Hill.

Credits

Last updated:	August 09, 2007
Author:	Monica Rhodes
Reviewed By:	Kathleen Romito, MD - Family Medicine, C. Dale Mercer, MD, FRCSC, FACS - General Surgery
Editors:	Kathleen M. Ariss, MS, Pat Truman, MATC