Small Bowel Prolapse (Enterocele) and Vaginal Vault Prolapse

What is small bowel prolapse?

Small bowel prolapsed also known as enterocele is a medical condition characterized by entry of a portion of the small bowel into the lower part of the pelvic cavity. It pushes the upper portion of the vagina leading to bulging of the area. In women with a history of surgical removal of the uterus (hysterectomy), this condition is also known as apical or vaginal vault prolapse. It usually involves part of the bladder and rectum besides the small intestine.

With progression of age and childbirth the muscles of the pelvic floor that support the pelvic organs become weak. In mild to moderate cases surgery is not essential but in severe cases surgical correction of the prolapse is essential.

Small Bowel Prolapse Symptoms

In case of mild prolapse there may not be any symptom. As the severity of the condition increase, there are a number of symptoms that becpme evident like :

  • Pulling sensation in the pelvic area which relieves only with lying down.
  • Abnormal feeling of fullness.
  • Pressure and pain in the pelvic area.
  • Pain in the lower back region.
  • Bulging of soft tissue in the upper part of the vagina.
  • Discomfort or pain during sexual intercourse.

In many women, along with prolapse of small bowel there may also be other pelvic organs which slip down.

  • Rectocele, also known as a posterior prolapse. where the rectum pushes the vaginal wall from back.
  • Cystocele, also known as anterior prolapsed, when the bladder pushes the vaginal wall from the front.
  • Uterine prolapse when the uterus tends to slip down from above.

Causes of Small Bowel Prolapse

The muscles of the pelvic floor maintain the proper position of different pelvic organs. With progression of age the muscles gradually become weak resulting in gradual decline of support for the pelvic organs. Common causes of weakening of the muscles of pelvic floor include :

  • Pregnancy and repeated childbirth.
  • Excessive straining in patients with chronic constipation.
  • Chronic cough.
  • Frequent lifting of heavy weights.
  • Being overweight or obese.

Pregnancy is one of the most common reasons for weakening of the pelvic muscle support. The muscles, ligaments and other tissue of the pelvic floor become stretched during pregnancy and childbirth thereby increasing the chance of downward movement of the pelvic organs in the future.

Risk factors

Common risk factors include :

  • Vaginal delivery of more than one babies, although not all the women with multiple pregnancy suffer from small bowel prolapse.
  • Progressive age leads to weakening of the pelvic floor muscles.
  • History of surgery in the pelvic region like surgical removal of the uterus (hysterectomy).
  • Increased intra-abdominal pressure due to chronic constipation, overweight and cough.
  • Smoking leads to a chronic cough and weakens the connective tissue of the pelvic floor over time.
  • Family history of small bowel prolapse especially in mothers of patients.
  • Connective tissue disorder leading to inherent deterioration of the strength of the pelvic floor.

Small Bowel Prolapse Treatment

Mild to moderate cases do not require surgical intervention. However, close monitoring for worsening of symptoms and introduction of pessary to prevent slipping of the small bowel downward is necessary. In severe cases, surgery is done to strengthen the pelvic floor along with repositioning of small bowel at its original position.

More Related Topics


Related pages


pain behind collarboneexternal ear swellingliver quadrantslip tremorheat rash crotchwhat causes pure liquid diarrheawhat can cause fishy odorspitting up black phlegmretaining fluid in abdomenlarge chunks of blood during periodpainful tracheafinger hurts at knucklewhite discharge early pregnancypain in upper abdomen and left sideear infection watery dischargecause of tailbone pain when sittingcoughing up white stuffdizziness due to lack of sleepsticky bloody dischargereason for burning sensation in anuscoughing blood with phlegmunderarm pain left sidepain in ovary before menstruationpain left under rib cagebotulism infectionmy burps smell like eggspure water diarrheafoul smell from the vaginaphlegm color yellowlymph nodes on rib cagebrown smelly discharge after miscarriageenlarged breast bonehand muscle atrophy causeswhat is tracheitispruritus itchingdiagnosis for diverticulitisovaries hurt pregnantburning sensation in stomach and anusdiarrhea and pain in right sidepainful lump groin femalelow blood anemiawhat causes scalp pimplesrecurrent diarrheabrown blood spotting between periodschest popping painfungus under breast picturesstrong odor from viginaexplosive liquid diarrheareason for stomach noisesbump on hard palate of mouthfungus spots on skinrt abdominal painwhat are the signs of a ruptured appendixoveractive saliva glandcrystal meths drug side effectswhat causes burning scalpbloated stomach picturesitchy scaly skin on legsclotting during periodsburning pain under right breast symptomsclavicle bone growthgreen poop in adults meansdiarrhea after large mealcoughing up dark green phlegmbaby stinky earlabia cystsbilateral shoulder pain causeswhat is hemidiaphragmbad odor during sexchafing crotch treatment2 month old baby spitting up clear liquidvaginal bleeding and odore-coli bacteria found in urinecontinuous cough with phlegmchest pain in the sternumbrown discharge with implantibs dark stoolrash from bracoughing up dark bloody mucus