Rectal prolapse: symptoms, causes, treatment?

Last reviewed: May 12, 2026 Last updated: May 12, 2026

Written by: Jay Hastings , CEO of PlexusDx

Jay Hastings is the CEO of PlexusDx, a precision health company focused on genetic testing, blood biomarker insights, and personalized wellness recommendations. He has more than 20 years of experience across healthcare innovation, genomics, laboratory operations, healthcare investing, and strategic finance. His work has included scaling healthcare startups, leading CLIA lab integrations, and helping expand consumer access to precision health tools.

Medically reviewed by: Jayden Lee, PharmD, EMBA

Jayden Lee, PharmD, EMBA, is the PlexusDx Medical Science Liaison with a PharmD and MBA specializing in pharmacogenomics and clinical product development, with a proven ability to bridge the gap between genomic research and practical patient outcomes. Dr. Lee has more than 10 years of professional experience in clinical pharmacy, academia, and research.

This article is part of the PlexusDx Education Hub — your resource for evidence-based guidance on digestive and pelvic-floor health. Browse all Diet & Genetics education

Rectal prolapse happens when part of the rectum — the last section of the large intestine — slips down and protrudes through the anus. It ranges from a subtle internal slippage to a visible bulge. It is uncomfortable and often distressing, but it is a well-understood condition that a qualified provider can evaluate and address.

What rectal prolapse is

Clinicians describe three broad patterns. Internal (occult) prolapse stays inside the anal canal. Mucosal prolapse involves only the rectal lining. Full-thickness prolapse is when the entire rectal wall telescopes outward. It is distinct from hemorrhoids, though the two are frequently confused because both can produce a bulge and bleeding.

Symptoms to recognize

Common signs include a feeling of a mass or bulge at the anus, especially during or after a bowel movement, mucus or blood discharge, and a sense of incomplete emptying. Many people experience worsening fecal incontinence or, conversely, constipation and straining. Early on, the tissue may retract on its own; later it may need to be pushed back manually.

What causes it

Rectal prolapse usually reflects a gradual weakening of the muscles and connective tissue that hold the rectum in place. Chronic straining from constipation, long-standing diarrhea, multiple vaginal childbirths, prior pelvic surgery, and the natural loss of tissue elasticity with age all contribute. Nerve injury affecting the pelvic floor and a naturally deep pouch of tissue behind the rectum can add risk.

It is most common in older adults, particularly women, but it also appears in younger people and children, where anatomy and, occasionally, underlying tissue disorders play a larger role.

The connective-tissue and genetic link

Connective tissue is the scaffolding that keeps pelvic organs supported. Genes that build collagen shape how strong and elastic that scaffolding is. Variants in COL3A1, which encodes type III collagen, are the classic example: severe COL3A1 mutations cause vascular Ehlers-Danlos syndrome, and connective-tissue disorders more broadly are associated with pelvic-floor weakness and prolapse.

Related collagen and elastin genes such as COL1A1 and LOXL1 influence tissue integrity too. For most people, no single gene causes rectal prolapse; instead, inherited differences in connective-tissue strength combine with lifetime mechanical stress. A family history of hernias, pelvic organ prolapse, or joint hypermobility can be a meaningful clue worth sharing with your provider.

How it is evaluated and approached

Diagnosis begins with a physical exam, sometimes asking you to bear down to reveal the prolapse, and may include defecography or anorectal testing. Approaches range from conservative measures — treating constipation, adding fiber and fluids, and pelvic-floor physical therapy — to surgical repair for full-thickness prolapse. The right path depends on the type, your symptoms, and your overall health, which is a decision for you and a qualified surgeon or gastroenterologist to make together.

Where genetic insight fits

The PlexusDx Precision Peptide Genetic Test looks at 14 pathways, 49 peptides, 150+ genetic insights across your DNA, including variants relevant to connective-tissue and tissue-repair pathways. It is an educational, pathway-level tool: it maps genes involved in connective tissue, collagen structure, and tissue-repair biology, not a diagnosis or a treatment plan. As the guiding principle at PlexusDx puts it, the test tells you about your biology — it does not tell you what to put in your body. Genetics is a guide, not a guarantee.

Genetic context cannot diagnose or fix a prolapse, but understanding your connective-tissue biology can help you and your provider weigh risk factors, especially if hypermobility or a family history of prolapse runs in your family.

Curious how your DNA shapes the pathways behind connective tissue and tissue repair? The Precision Peptide Genetic Test reads 14 pathways, 49 peptides, 150+ genetic insights across your genome, giving you pathway-level context to bring to a qualified provider. Test before you invest in a plan — know, don’t guess.

Frequently Asked Questions

Is rectal prolapse the same as hemorrhoids?

No. Hemorrhoids are swollen blood vessels in the anal canal, while rectal prolapse is the rectal wall itself slipping through the anus. Both can bulge and bleed, which causes confusion, but they are different conditions with different management. A provider can distinguish them on examination.

Can rectal prolapse be inherited?

Not directly, but inherited connective-tissue strength plays a role. Variants in collagen genes such as COL3A1 and conditions like Ehlers-Danlos syndrome raise the risk of pelvic-floor weakness and prolapse. Most cases come from a mix of tissue biology and lifetime strain rather than a single inherited gene.

Does straining cause rectal prolapse?

Chronic straining is a major contributor. Long-standing constipation, repeated heavy lifting, and prolonged straining gradually weaken the muscles and ligaments supporting the rectum. Managing constipation with fiber, fluids, and provider-guided habits is a core part of both preventing progression and supporting recovery after treatment.

When should I see a doctor?

See a healthcare provider promptly if you notice a bulge at the anus, persistent mucus or bleeding, worsening incontinence, or tissue that will not retract. Early evaluation gives the most options. Rectal prolapse is treatable, and outcomes are generally better when it is addressed sooner rather than later.

This article is part of the PlexusDx Education Hub. Browse all Diet & Genetics education

The Precision Peptide Genetic Test analyzes how your genes influence peptide-related biological pathways. It does not recommend, prescribe, or determine which peptides you should use. Consult a qualified healthcare provider before beginning any peptide protocol.

Medical and Editorial Standards

Medical review process: This article was reviewed for medical accuracy, scientific clarity, evidence alignment, and appropriate discussion of genetics, medications, supplements, biomarkers, and health-related claims.

Sources and evidence: PlexusDx educational content is developed using peer-reviewed research, clinical literature, reputable medical references, and, where applicable, public health or regulatory guidance. References are included at the end of the article when scientific, medical, or health-related claims are discussed.

Commercial transparency: PlexusDx offers genetic testing, blood biomarker testing, personalized supplement recommendations, and related precision wellness services. Product mentions are intended to help readers understand available options and should not be interpreted as medical advice.

Important disclaimer: PlexusDx educational content is for informational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making decisions about medications, supplements, genetic testing, lab testing, or health-related care.