Most patients are able to detect the presence of a mass, especially following defecation or strenuous activity. In more advanced cases, this may be present when they stand or walk. Irritation to the rectal mucosa caused by recurrent prolapse results in a mucous discharge with some associated bleeding. Some patients may present because of blood-stained mucus on their undergarments, others because of fecal incontinence caused by associated anal sphincter weakness. In pediatric patients, parents often mistakenly believe that the prolapsed mucosa is hemorrhoids.
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