How is pediatric rectal prolapse treated?

Updated: Dec 12, 2019
  • Author: Jaime Shalkow, MD, FACS; Chief Editor: Carmen Cuffari, MD  more...
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Patients who present with a prolapsed rectum should undergo prompt manual reduction. Conservative management is appropriate in selected patients. Treatment should be directed to the underlying cause, since once treated, conservative management is usually successful. Cases of difficult reduction and patients with recurrent episodes are less likely to respond to conservative measures.

The benefit of using biofeedback in patients with chronic straining or paradoxical contractions of the anal sphincters is yet to be elucidated. For many years, case series and expert opinions proposed biofeedback as a first-choice treatment option for fecal incontinence. Most case series reported positive outcomes in over 70% of patients. [38]

Surgical treatment is reserved for patients who do not improve with conservative management or patients with complicated rectal prolapse (eg, recurrent rectal prolapse, painful episodes, ulceration, rectal bleeding). [27]

In patients with cystic fibrosis, initiation of adequate pancreatic enzyme replacement usually results in cessation of rectal prolapse.

Some authors have reported excellent results with injection sclerotherapy. [58, 41, 91]

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