Rectal Prolapse: Symptoms, Concerns, and When to Seek Help

I am experiencing a protrusion from my anus when I exert myself (I have a picture...)?

I'm experiencing a situation where a large mass protrudes from my anus when I strain during bowel movements.
This has been happening for many years, and I haven't paid much attention to it.
Today, I bought a new camera and, out of curiosity, took some pictures of my anus while having a bowel movement.
I was shocked by what I saw.
The images (which are somewhat unpleasant as they were taken during defecation) show the following:
1.
[Image 1](http://img197.imageshack.us/img197/6082/dscf0362g.jpg)
2.
[Image 2](http://img517.imageshack.us/img517/6602/dscf0367.jpg)
3.
[Image 3](http://img687.imageshack.us/img687/951/dscf0378m.jpg)
4.
[Image 4](http://img704.imageshack.us/img704/6928/dscf0379i.jpg)
5.
[Image 5](http://img691.imageshack.us/img691/6868/dscf0386h.jpg)
In the first four images, the colors appear more vivid due to the camera settings.
Whenever I strain, this large mass protrudes, but it can retract after I finish my bowel movement.
If I only wipe with toilet paper without washing, I find it impossible to clean myself properly.
Sometimes, after wiping, I notice a small amount of blood that resembles the color of fresh blood from a minor injury.
Additionally, I occasionally expel a clear or slightly yellowish fluid that has a fishy odor.

When I squat (like a frog), I feel like something is protruding from my anus, and it feels as if I might have an accident in my pants.
However, if I strain, this sensation goes away, and using a one-foot squat method also alleviates it.

I would like to know if this situation is normal or abnormal.
If I ignore it, could it lead to any issues? How should I explain this to a doctor if I decide to visit a clinic? Thank you for your help.

A Yi O, 20~29 year old female. Ask Date: 2010/03/07

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, the imaging appears to show a rectal prolapse, which may be related to hemorrhoids.
It is advised to avoid irritating foods and maintain normal bowel movements.
A consultation with a colorectal surgeon for examination and treatment is recommended.
Wishing you good health.
Sincerely, Dr.
Lin Ming-Hui, Taoyuan Hospital, Department of Health.

Reply Date: 2010/03/07

More Info

Rectal prolapse is a condition where part of the rectum protrudes through the anus, often occurring during bowel movements or when straining. Based on your description, it seems that you are experiencing symptoms consistent with rectal prolapse, especially since you mentioned that a "large piece" appears when you exert pressure during bowel movements, but it retracts afterward. This condition can be alarming, and it's understandable that you have concerns about it.

Symptoms of Rectal Prolapse
The symptoms of rectal prolapse can include:
- A visible bulge or protrusion from the anus, especially during bowel movements.

- Discomfort or pain in the rectal area.

- Bleeding, which may occur if the tissue is irritated or damaged.

- Mucus discharge, which can be clear or slightly yellow and may have an unpleasant odor.

- Difficulty cleaning the area after a bowel movement, leading to hygiene issues.

Concerns and Risks
While rectal prolapse can sometimes be managed conservatively, it is essential to understand that leaving it untreated can lead to complications. These may include:
- Increased discomfort or pain.

- Worsening of the prolapse, making it more difficult to manage.

- Potential for strangulation of the prolapsed tissue, which can lead to severe complications requiring emergency medical intervention.

- Chronic irritation or injury to the rectal tissue, which can lead to infections or other issues.

When to Seek Help
Given that you have been experiencing these symptoms for several years, it is advisable to seek medical attention. You should consider visiting a healthcare provider, preferably a gastroenterologist or a colorectal surgeon, who specializes in conditions of the rectum and anus. When you go to the doctor, you can describe your symptoms as follows:
- Mention that you experience a protrusion from the anus during bowel movements.

- Describe any associated symptoms, such as bleeding, mucus discharge, or pain.

- Explain how long you have been experiencing these symptoms and any changes over time.

Diagnosis and Treatment
The doctor will likely perform a physical examination and may recommend additional tests, such as a colonoscopy, to rule out other conditions. Treatment options may include:
- Conservative Management: Dietary changes to prevent constipation, pelvic floor exercises, and possibly the use of stool softeners.

- Surgical Options: If the prolapse is severe or does not respond to conservative measures, surgical intervention may be necessary to repair the prolapse.

Conclusion
In summary, your symptoms suggest that you may be dealing with rectal prolapse, which is not uncommon but should not be ignored. Seeking medical advice is crucial to prevent potential complications and to explore treatment options that can improve your quality of life. Remember, it is essential to communicate openly with your healthcare provider about your symptoms and concerns. They are there to help you, and discussing these issues can lead to effective management and relief from your symptoms.

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