Skip to main contentLast updated: 04-Nov-2026
Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
GI & Proctology Surgeon
Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad · 18 years of experience
In short
The rectum slips out when its supports in the pelvis grow slack. Long-term straining, childbirth, age and weak nerves all add to the strain on those supports.
Doctors first ask whether the whole wall has come down, in rings, or only the lining, in folds. That one point decides whether it is rectal prolapse or piles.
Prolapse can also stay hidden inside the body. It is graded on a special X-ray or MRI, and treatment follows your symptoms, not the picture.
The full picture of rectal prolapse and its treatment is on our rectal prolapse surgery page. This post explains why it happens and how it is classified.
The rectum is the last part of the bowel. In prolapse it folds in on itself, like a sock being turned inside out, and then slides down and out through the anus.
No single fault causes it. Several supports around the rectum grow slack together, and straining then pushes the loose bowel downward.
| What weakens | What it normally does | What happens when it fails |
|---|---|---|
| Pouch in front of the rectum | Stays shallow | A deep pouch lets bowel press down on the rectum |
| Loose, long rectum and sigmoid colon | Is held to the back of the pelvis | The bowel can fold and telescope |
| Supports at the back and sides | Hold the rectum in place | The rectum drops and turns |
| Pelvic floor muscle sling | Closes the pelvic gap and keeps the bowel angled | The gap widens and the bowel can pass through |
| Anal muscle and its nerves | Keep the anus closed | Leaking of stool or gas, and less hold on the rectum |
Each operation for prolapse aims at one or more of these faults. That is why the type of repair is matched to the person.
Rectal prolapse is far more common in women, and in older people. Still, anyone who strains for years, or has certain nerve or tissue problems, can develop it.
The doctor looks at the pattern of the folds. Rings that go all the way round mean the whole rectal wall has come out. Folds that run like spokes mean the lining or piles.
| Feature | Full rectal prolapse | Lining prolapse or piles |
|---|---|---|
| Folds | Rings that go all the way round | Folds like spokes of a wheel |
| Layers that come out | All layers of the rectal wall | The lining only |
| Groove around the mass | A groove between the mass and the anus | No deep groove |
| What it needs | A repair that fixes the rectum in place | Care for piles or the lining, not a rectum repair |
Mixing the two is a common mistake. A person sent for a prolapse repair who only has piles gets the wrong operation, and the reverse is just as wrong.
Internal prolapse is a fold of the rectum that stays inside the body. An X-ray or MRI taken while you strain shows how far it travels, and doctors grade it from one to five.
The grade guides us, but your symptoms decide. A high grade with no complaint is often left alone, while a lower grade with real blockage may need treatment.
Several problems can look like something coming down. A proper examination is needed. A growth at the tip of the mass, or a long-standing sore, must never be called a simple prolapse.
In children the cause is usually different, and it often settles without an operation. Poor nutrition, long bouts of diarrhoea and worms may be behind it. So may a lung and gut condition called cystic fibrosis. A doctor should look for these.
In adults, rectal prolapse rarely goes away on its own. It tends to grow. The longer it lasts, the more the anal muscle is stretched, and the more leaking you may notice.
No. Piles are soft cushions in the anal canal. In rectal prolapse the wall of the rectum itself slides out, often in rings. An examination tells them apart, and the treatment is different.
Weak supports in the pelvis, long-term straining, past childbirth or pelvic surgery, and age all play a part. Nerve disease can add to it. Most people have more than one cause.
Childbirth can stretch the pelvic floor and its nerves, and a womb removal can change the support at the front. Women are affected far more often, but men can have it too.
Yes. A young adult who strains a lot, or whose pelvic floor muscles tighten when they should relax, can develop it. Children can too, but theirs is a different problem that often settles.
The rectum folds in on itself inside the body and does not come out. It can cause a feeling of blockage and incomplete emptying. A special X-ray or MRI while you strain shows it.
No. Many are found by chance and cause no trouble. Treatment is planned from your symptoms, not from the picture alone.
See one when you notice tissue coming out, leaking, bleeding or a blocked feeling. Tissue that stays out, turns dark and cannot be pushed back needs care on the same day.
For the whole range of prolapse care, start at the rectal prolapse surgery page. For questions before you travel, call +91-63555-64601.
Dr Harsh Shah — Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
Dr. Jivraj Mehta Hospital, Dr Jivraj Mehta Marg, Vasna, Ahmedabad 380007.
Consultations, review of reports and scans, operations and follow-up. OPD Monday to Saturday, 9 am to 5 pm.
Appointments: +91-63555-64601 · +91-63590-11009 · Hospital 079-2663 6363
Directions to the hospital · WhatsApp +91-63555-64601
Is something coming out when you pass stool, and are you not sure if it is piles or something else? Bring your questions and any reports. Dr Harsh Shah will examine you and explain what is happening, step by step. Call, or send a message on WhatsApp. Call +91-63555-64601 Ask on WhatsApp
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