Preventing rectal prolapse comes down to reducing the forces that push rectal tissue downward and strengthening the muscles that hold it in place. The biggest modifiable risk factor is chronic straining during bowel movements, so most prevention strategies focus on keeping stools soft, training your pelvic floor, and protecting your body during physical effort. Rectal prolapse is uncommon overall, affecting roughly 2.5 per 100,000 people each year, but it disproportionately affects women over 50, who account for 80 to 90 percent of adult cases.
Keep Stools Soft With Fiber and Fluids
Straining on the toilet is the single most controllable trigger for rectal prolapse. Hard, difficult-to-pass stools force you to bear down repeatedly, increasing pressure inside your abdomen and stretching the tissues that anchor your rectum. The goal is stools that pass easily without effort.
Aim for 25 to 35 grams of fiber per day from a mix of sources: fruits, vegetables, legumes, whole grains, and seeds. Fiber adds bulk and moisture to stool, making it easier to move through the colon. If your current intake is low, increase gradually over a week or two to avoid bloating and gas. Pair fiber with adequate fluids, at least six to eight glasses of water or other decaffeinated liquids daily. Fiber without enough fluid can actually make constipation worse. Naturally sweetened fruit and vegetable juices and clear soups count toward your daily total, though plain water is the simplest option.
If diet alone isn’t enough, bulk-forming fiber supplements (like psyllium) are generally safe for long-term use. Stimulant laxatives, on the other hand, should be used sparingly. Long-term stimulant laxative use is linked to structural changes in the colon wall, including loss of the normal folds that help move stool along, which may signal nerve or muscle damage over time.
Strengthen Your Pelvic Floor
The pelvic floor is a hammock of muscles running from your pubic bone to your tailbone. These muscles support your rectum, bladder, and (in women) uterus. When they weaken from aging, childbirth, or chronic straining, the rectum loses a key layer of structural support.
Pelvic floor exercises (often called Kegels) can rebuild that support. The technique is straightforward: tighten the muscles you’d use to stop the flow of urine, hold for a count of 10, then fully relax for a count of 10. Do 10 repetitions, three to five times a day. Most people notice improvement within four to six weeks, with more significant changes around three months. Start with an empty bladder, and resist the urge to do extra sets. Over-exercising these muscles causes fatigue and can actually worsen symptoms rather than help.
Once you’ve built some baseline strength, practice a single quick contraction at moments when pressure spikes, like standing up from a chair, coughing, or lifting something. This trains the muscles to fire reflexively when you need them most.
Fix Your Toilet Posture
The standard sitting position on a Western toilet isn’t ideal for your anatomy. When you sit upright at a 90-degree angle, a muscle called the puborectalis maintains a kink in the rectum that you have to strain against to evacuate. A squatting posture opens the angle between the rectum and anal canal to about 100 to 110 degrees, straightening the path and reducing the effort required.
You don’t need to install a squat toilet. A simple footstool placed in front of the toilet, raising your knees above your hips, achieves much of the same effect. One study found that using a footstool cut average defecation time roughly in half (about 56 seconds versus 113 seconds sitting normally) and nearly halved the strain rating participants reported. Leaning your upper body slightly forward while your feet are elevated can further improve results, particularly for older adults.
Beyond posture, don’t linger. Sitting on the toilet for extended periods (scrolling your phone, reading) puts sustained downward pressure on rectal tissue. Go when you feel the urge, and if nothing happens within a few minutes, get up and try again later.
Protect Yourself During Heavy Lifting
Every time you lift something heavy, pressure inside your abdomen spikes. Repeated heavy lifting over months or years can gradually weaken the pelvic floor and stretch the connective tissue supporting the rectum. This applies to people in physically demanding jobs (warehouse workers, nurses, construction workers) as well as those who lift weights at the gym.
Proper form matters more than avoiding lifting entirely. Exhale during the exertion phase of a lift rather than holding your breath, which traps pressure in your abdomen. Bend at the knees instead of the waist. Engage your core and pelvic floor before you lift rather than bracing only your upper body. If your job involves repetitive heavy lifting, taking brief recovery breaks and using mechanical aids when available can reduce the cumulative load on your pelvic floor over a career.
Consider Biofeedback for Chronic Straining
Some people strain not because their stool is hard, but because their pelvic floor muscles contract when they should be relaxing. This pattern, called pelvic floor dyssynergia, essentially creates a closed door that the body tries to force open with more abdominal pressure. If you consistently feel like you’re pushing hard but nothing moves, or you frequently feel incomplete evacuation, this coordination problem may be the cause.
Biofeedback therapy uses sensors to show you, in real time, what your pelvic floor muscles are doing during a simulated bowel movement. A therapist then coaches you to relax those muscles at the right moment instead of clenching them. In a randomized trial, 80 percent of patients with dyssynergia who received biofeedback showed major improvement, compared to just 22 percent of those treated with laxatives alone. Those gains held at two years. Patients reported less straining, less sensation of blockage, less abdominal pain, and more unassisted bowel movements. Biofeedback typically involves a series of office visits over several weeks, and the skills you learn carry over into daily life.
Know the Early Warning Signs
Rectal prolapse often develops gradually. In its earliest stage (sometimes called internal prolapse or internal intussusception), the rectal lining starts to fold inward but hasn’t yet pushed through the anal opening. You may not see anything externally, but you might notice mucus discharge on toilet paper, a persistent feeling of incomplete evacuation, or minor fecal leakage.
One source of confusion is the difference between prolapse and hemorrhoids. Both can cause tissue to bulge from the anus, but prolapse involves the full circumference of the rectal wall and produces circular mucosal folds. Hemorrhoids, by contrast, create radial folds, like spokes of a wheel. If you notice tissue protruding during or after a bowel movement, the pattern of folds is the key distinguishing feature a clinician will look for.
Catching the problem early, before the rectum protrudes fully, gives you the widest range of non-surgical options: dietary changes, pelvic floor training, biofeedback, and posture correction. Once a full-thickness prolapse develops, surgery is typically the only effective treatment.
Who Is Most at Risk
Women over 50 carry the highest risk, largely due to the cumulative effects of pregnancy, childbirth (especially prolonged labor), hormonal changes after menopause, and age-related weakening of connective tissue. But rectal prolapse can also occur in men and in younger adults with chronic constipation, connective tissue disorders, or neurological conditions that affect pelvic floor function.
If you fall into a higher-risk group, the strategies above aren’t just helpful, they’re particularly important to adopt early. Maintaining soft stools, building pelvic floor strength, using a footstool, and avoiding unnecessary straining are low-effort habits that compound over time. The goal is to reduce the daily mechanical stress on your rectum before damage accumulates to the point where tissue begins to shift.