Small bowel prolapse, also called enterocele (EN-tur-o-seel), occurs when the small intestine (small bowel) descends into the lower pelvic cavity and pushes at the top part of the vagina, creating a bulge. The word “prolapse” means to slip or fall out of place.
Childbirth, aging and other processes that put pressure on your pelvic floor may weaken the muscles and ligaments that support pelvic organs, making small bowel prolapse more likely to occur.
To manage small bowel prolapse, self-care measures and other nonsurgical options are often effective. In severe cases, you may need surgical repair.
Increased pressure on the pelvic floor is the main reason for any form of pelvic organ prolapse. Conditions and activities that can cause or contribute to small bowel prolapse or other types of prolapse include:
- Pregnancy and childbirth
- Chronic constipation or straining with bowel movements
- Chronic cough or bronchitis
- Repeated heavy lifting
- Being overweight or obese
Pregnancy and childbirth
Pregnancy and childbirth are the most common causes of pelvic organ prolapse. The muscles, ligaments and fascia that hold and support your vagina stretch and weaken during pregnancy, labor and delivery. Not everyone who has had a baby develops pelvic organ prolapse. Some women have very strong supporting muscles, ligaments and fascia in the pelvis and never have a problem.
Mild small bowel prolapse may produce no signs or symptoms. However, if you have significant prolapse, you might experience:
- A pulling sensation in your pelvis that eases when you lie down
- A feeling of pelvic fullness, pressure or pain
- Low back pain that eases when you lie down
- A soft bulge of tissue in your vagina
- Vaginal discomfort and painful intercourse (dyspareunia)
Many women with small bowel prolapse also experience prolapse of other pelvic organs, such as the bladder, uterus or rectum.
When to see a doctor
See your doctor if you develop signs or symptoms of prolapse that bother you.