Name of the Condition

• Anal Prolapse
• Also known as Rectal Prolapse, K62.2 (ICD Code)

Summary

• Anal prolapse, commonly referred to as rectal prolapse, is a medical condition where part of the rectum protrudes from the anus. It often presents as a bulge that appears through the anal opening and may protrude during activities like bowel movements or standing.

Causes

• Anal prolapse can be caused by weakened pelvic floor muscles or ligaments, chronic constipation, long-term straining during bowel movements, prior surgery or injury to the rectal area, and nerve damage that affects the pelvic region.

Risk Factors

• Risk factors include age (more common in older adults), a history of chronic constipation or straining, multiple childbirths in women, neurological diseases affecting muscle control (e.g., spinal cord injury, multiple sclerosis), and prior pelvic surgery.

Symptoms

• Symptoms include a visible bulge or protrusion from the anus, rectal bleeding, fecal incontinence, mucus discharge, a sensation of fullness, and discomfort or pain in the anal area.

Diagnosis

• Diagnosis is typically made through a physical examination by a healthcare provider. Additional tests such as a colonoscopy, defecography, or anorectal manometry may be conducted to assess the extent of prolapse and rule out other conditions.

Treatment Options

• Treatment can involve lifestyle changes like dietary adjustments and exercises to strengthen the pelvic floor. For more severe cases, surgical options such as rectopexy (fixation of the rectum) may be recommended. Injections, biofeedback therapy, and medications might also be considered depending on individual assessments.

Prognosis and Follow-Up

• The prognosis for anal prolapse varies based on severity and treatment. Early detection and treatment can lead to good outcomes. Follow-up care is essential to monitor symptoms and manage any recurrence.

Complications

• Potential complications include persistent discomfort, recurrent infection or ulcers in the prolapsed tissue, and worsening fecal incontinence. Untreated prolapse can lead to severe complications requiring emergency intervention.

Lifestyle & Prevention

• Preventive measures include adopting a high-fiber diet to prevent constipation, regular pelvic floor exercises, staying hydrated, avoiding excessive straining during bowel movements, and maintaining a healthy weight.

When to Seek Professional Help

• Seek immediate medical attention if you notice a persistent or painful protrusion from the anus, experience severe pain, or have significant bleeding during bowel movements.

Additional Resources

• American Society of Colon and Rectal Surgeons (fascrs.org)
• Mayo Clinic's information on Rectal Prolapse

Tips for Medical Coders

• Ensure correct identification of anal prolapse as distinct from other rectal and anal conditions.
• Verify clinical documentation to accurately assign the ICD code K62.2. Avoid confusion with similar gastrointestinal prolapse diagnoses such as prolapse of the rectal mucosa alone.