See also ANAL FISSURE; CONGENITAL HEART DISEASE;
CYSTOCELE; ENDOSCOPY; HEMORRHOIDS; ILEUS; MECO-
NIUM; PROCTITIS; RECTOCELE.
rectal prolapse Protrusion of the rectal mucosa
(lining of the RECTUM) through the ANUS. Rectal
prolapse often affects women beyond MENOPAUSE
who experienced trauma during vaginal CHILDBIRTH
and have residual weakness of the pelvic struc-
tures. However, rectal prolapse occasionally affects
men, usually those who are elderly. Long-term,
chronic CONSTIPATIONis a common factor when rec-
tal prolapse occurs in women who have not given
birth or in men. Prolapse of other pelvic organs,
such as the BLADDER(CYSTOCELE), is also common.
Rectal prolapse generally is apparent with physical
examination, though the doctor often will per-
form sigmoidoscopy to rule out other conditions.
Treatment is surgery to repair the rectal wall.
See also ENDOSCOPY; HEMORRHOIDS; ILEUS; RECTAL
FISTULA; RECTOCELE.
rectocele A weakness that develops in the wall
of tissue that separates the RECTUM from the
VAGINA, called the rectovaginal wall, causing the
rectum to protrude into the vagina. Rectocele, a
type of HERNIA, most commonly appears after
MENOPAUSE. Circumstances that chronically stress
the muscles of the perirectal area, such as strain-
ing with bowel movements or frequent coughing
due to pulmonary conditions, are frequent causes.
Weakening of or damage to the perineal structures
during vaginal CHILDBIRTHmay also contribute to
rectocele. Many women who have small rectoce-
les do not have symptoms. Larger rectoceles may
produce symptoms that include the sensation of
pressure in the vagina, pelvic PAIN, painful vaginal
intercourse, and occasionally FECAL INCONTINENCE.
Treatment options include KEGEL EXERCISES to
strengthen the pelvic and vaginal muscles, weight
loss to decrease stress on the pelvic muscles, and
the insertion of a PESSARY, a fitted ring placed in
the vagina to support the rectovaginal wall. Pes-
saries may cause irritation and INFLAMMATION,
however; and women may find them uncomfort-
able. Surgery to repair the herniation becomes an
option when other treatments fail to correct the
problem and symptoms continue.
See also CYSTOCELE; PELVIC EXAMINATION; RECTAL
PROLAPSE; SURGERY BENEFIT AND RISK ASSESSMENT.rectum The segment of the COLONbetween the
sigmoid colon and the ANUS. About six inches long,
the rectum retains solid digestive waste until a
BOWEL MOVEMENTexpels it. The SPINAL CORDregu-
lates the NERVEimpulses that initiate the reflexive
contractions of the rectum that result in bowel
movements. The walls of the rectum are smooth
and flexible, allowing it to expand to accommo-
date collected fecal material. The rectum is a fre-
quent site of intestinal polyps and is vulnerable to
CANCER. Other health conditions that can involve
the rectum include ulcerative COLITIS, Crohn’s dis-
ease, and DIVERTICULAR DISEASE.COMMON CONDITIONS THAT CAN AFFECT THE RECTUM
COLITIS COLORECTAL CANCER
CONSTIPATION DIARRHEA
DIVERTICULAR DISEASE FAMILIAL ADENOMATOUS POLYPOSIS(FAP)
FECAL IMPACTION HIRSCHSPRUNG’S DISEASE
INTESTINAL POLYP PROCTITIS
RECTAL FISTULA RECTAL PROLAPSE
RECTOCELE SPINAL CORD INJURYFor further discussion of the rectum and colon
within the context of gastrointestinal structure
and function, please see the overview section “The
Gastrointestinal System.”
See also BARIUM ENEMA; CECUM; COLONOSCOPY;
COLOSTOMY; CYSTIC FIBROSIS; DIGITAL RECTAL EXAMINA-
TION(DRE); ENDOSCOPY; ENEMA; FECAL INCONTINENCE;
INTESTINAL POLYP; SMALL INTESTINE.rectum 87