Rectal Prolapse: Overview, Symptoms, Diagnosis, and Ayurvedic Management

Rectal prolapse happens when the rectum — the last part of the large intestine — slips down and protrudes through the anus. The term prolapse refers to any body part that falls out of its normal position because supporting tissues weaken.

Symptoms

Most people first notice a reddish mass bulging out of the anus, especially while straining during a bowel movement. In the beginning, the rectum may slide back inside on its own. As the condition progresses, it may stay outside and require manual repositioning.

People with rectal prolapse often struggle with bowel control, which can lead to fecal incontinence. Many also experience constipation, diarrhea, or both. Some notice blood or mucus leaking from the rectum. Others describe a constant feeling of incomplete evacuation even after passing stool.

Causes

Doctors do not always find a single clear cause for rectal prolapse. However, weak pelvic floor muscles and ligamentsusually play a major role. Although many people link rectal prolapse to childbirth, research shows that about one-third of affected women have never given birth. This pattern suggests that other factors — such as chronic constipation, aging, nerve damage, or long-term straining — also contribute significantly.

Diagnosis

Because rectal prolapse can sometimes resemble hemorrhoids, proper medical evaluation is essential. To confirm the diagnosis and rule out other conditions, doctors may recommend several tests.

First, doctors perform a digital rectal exam. They insert a gloved, lubricated finger into the rectum to assess sphincter strength and check for abnormalities. They often ask the patient to bear down, which helps reveal the prolapse.

Next, they may conduct anal manometry. During this test, a thin, flexible tube with a small balloon goes into the rectum. The balloon measures sphincter tightness and helps doctors evaluate rectal sensation and function.

Doctors sometimes recommend a colonoscopy to rule out polyps, tumors, or colon cancer. This procedure allows them to examine the entire colon using a flexible scope.

They may also order defecography, an imaging study that uses contrast material with X-ray or MRI. This test shows structural changes and reveals how well the rectal muscles work during bowel movements.

Ayurvedic Perspective and Treatment Principles

Ayurveda classifies rectal prolapse primarily as a Vata disorder affecting the lower digestive tract. Therefore, treatment focuses on balancing Vata, improving bowel movement, and strengthening supportive tissues.

Core Treatment Principles

Firstly, Pravahika Chikitsa principles are applied, which address bowel dysfunction and inflammation.
Alongside this, Vatanulomana therapy is used to regulate the downward movement of Vata and ease bowel elimination.
Additionally, internal oleation with medicated ghee (Ghrita Panam), especially those prepared with madhura (sweet) and amla (sour) herbs, is recommended to nourish tissues and reduce dryness.

Commonly Used Ayurvedic Formulations

Kashayam (Herbal Decoctions)

These help improve digestion, reduce inflammation, and balance Vata:

• Kalashakadi Kashayam
• Kaidaryadi Kashayam
• Ambasthadi Kashayam
• Sukumaram Kashayam

Churnam (Herbal Powders)

Used to regulate digestion and bowel movements:

• Dadimastaka Churna
• Yavanyadi Churna
• Kapithastaka Churna

Gulika (Herbal Tablets)

Often prescribed for digestive and Vata-related disorders:

• Ashtakshari Gulika
• Charngeriyadi Gulika
• Vilvadi Gulika

Ghritam (Medicated Ghee)

These nourish tissues and support bowel function:

• Charngeriyadi Ghritam
• Sukumara Ghritam
• Manicka Ghritam

Lehyam (Herbal Electuaries)

Used for strengthening and mild bowel regulation:

• Sukumara Lehyam

Rasa Oushadhas (Herbo-mineral Preparations)

Traditionally used in specific chronic conditions:

• Panchamla Parpati
• Rasa Parpati

External Therapies

In addition to internal medicines, external treatments are often included.

Snehanam (oleation therapy) may be done using medicated oils or ghee applied locally (Pichu). Common options include:

• Murivenna Taila
• Mahatiktakam Ghrita
• Shatadhouta Ghrita

Bandhanam (supportive binding) techniques such as Gophana Bandhanam may be used to provide local support.

Vasti (medicated enema therapy) is considered especially beneficial for Vata disorders.
Anuvasana Vasti, using oils like:

• Murivenna Taila
• Pippalyadi Tailam
• Dhanvantara Tailam

is typically administered in doses ranging from 75 ml to 150 ml, depending on the individual’s condition and strength.

Important Note

While Ayurvedic management can be supportive, rectal prolapse is a structural condition that sometimes requires surgical correction, especially in advanced cases. Therefore, proper evaluation by a qualified medical professional is essential before starting any treatment.