Small bowel prolapse occurs in women when the small intestine (small bowel) slides down into the lower pelvic cavity and pushes at the top part of the vagina, creating a bulge. The word "prolapse" refers to slipping or falling out of place.

Pressure on the pelvic floor may weaken the muscles and ligaments that support pelvic organs like during childbirth, aging and other processes, making small bowel prolapse more likely to occur.

Symptoms

Mild small bowel prolapse may produce no signs or symptoms. In significant prolapse, the following symptoms might be experienced:

  • A feeling of pulling in the pelvis that eases when you lie down
  • A feeling of pelvic fullness, pressure or pain
  • Pain in the low back that eases when you lie down
  • A soft bulge of tissue in the vagina
  • Vaginal discomfort and painful intercourse (dyspareunia)

Causes

Factors that increase the risk of developing small bowel prolapse include:

  • Pregnancy and childbirth. Vaginal delivery of one or more children contributes to the weakening of the pelvic floor support structures, increasing the risk of prolapse.
  • Age. Small bowel prolapse occurs more often with increasing age.
  • Pelvic surgery. Removal of the uterus (hysterectomy) or surgical procedures to treat incontinence may increase the risk.
  • Increased abdominal pressure. Overweight increases pressure inside the abdomen, which augments the risk of developing small bowel prolapse.
  • Smoking. Smoking is associated with developing prolapse because smokers frequently cough, increasing abdominal pressure.
  • Family history. The chances of having prolapse are greater if the mother experienced small bowel prolapse.
  • Connective tissue disorders. One may be genetically prone to prolapse due to weaker connective tissues in one’s pelvic area.

Risk Factors

Risk factors include:

  • Chronic constipation.
  • Straining to pass bowel motions.
  • Weakened pelvic floor muscles.
  • Weakened anal sphincter muscles.
  • Weakening of the muscles with ageing.

Complications

Complications of small bowel prolapse include:

  • Risk of damage to the rectum, such as ulceration and bleeding
  • Incarceration – the rectum cannot be manually pushed back inside the body
  • Strangulation of the rectum when the blood supply is reduced
  • Death and decay (gangrene) of the strangulated section of the rectum.

Prevention

You may be able to lower the chances of small bowel prolapse with these strategies:

  • Prevent constipation. Eat high-fiber foods, drink plenty of fluids and exercise regularly to help prevent having to strain during bowel movements Maintain a healthy weight. In cases of overweight, weight loss can decrease the pressure inside the abdomen.
  • Treat a chronic cough. Constant coughing increases abdominal pressure
  • Quit smoking. Smoking contributes to chronic coughing.
  • Avoid heavy lifting. Lifting heavy objects increases abdominal pressure.