In the pediatric population, rectal prolapse is most commonly a self-limited and benign condition. Always consider rectal prolapse as a presenting sign of an underlying condition and not a discrete disease entity unto itself. Rectal prolapse was more common 50 years ago than now, and this decreased occurrence is thought to be due to improved nutrition and hygiene in industrialized countries. Most cases of childhood prolapse occur in patients younger than 4 years, with the highest incidence in the first year of life. Though cystic fibrosis is not a likely diagnosis in patients presenting with rectal prolapse, a sweat test is indicated in all patients presenting without an underlying anatomic abnormality.
Most prolapses reduce spontaneously.
Failure to reduce may lead to venous stasis, edema, and possibly ulceration. Long-standing or frequent recurrent prolapse may lead to proctitis. No racial predilection exists. This is in contrast to the adult population, in which it is 5 times more common in women. Highest incidence is in the first year of life.