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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
Perception of rectal prolapse symptoms in patients with psychiatric disorders
Nouf Akeel, Charlotte Mary Rajasingh, Michelle Earley, Sydni Au Hoy, Leila Neshatian, Ekene Enemchukwu, Kavita Mishra, Brooke Gurland
Nouf Akeel, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Makkah al Mukarramah, Saudi Arabia
Charlotte Mary Rajasingh, Michelle Earley, Sydni Au Hoy, Department of Surgery, Stanford University, Stanford, CA 94305, United States
Leila Neshatian, Division of Gastroenterology and Hepatology, Stanford University, Redwood City, CA 94063, United States
Ekene Enemchukwu, Department of Urology, Center for Academic Medicine, Stanford University, Stanford, CA 94305, United States
Kavita Mishra, Department of Obstetrics and Gynecology, Stanford Pelvic Health Center, Stanford University School of Medicine, Stanford, CA 94305, United States
Brooke Gurland, Department of Colorectal Surgery, Stanford University, Stanford, CA 94305, United States
Author contributions: Akeel N contributed to data interpretation; Akeel N, Neshatian L, Enemchukwu E, and Gurland B edited the manuscript; Rajasingh CM and Hoy SA reviewed the manuscript; Earley M, Neshatian L, Enemchukwu E, Mishra K, and Gurland B conception and design of the study; Earley M, Rajasingh CM, and Hoy SA contributed to data collection; Earley M participated in the statistical analyses, and interpretation of results to ensure accuracy, validity, and scientific rigor; Gurland B contributed to supervision. All authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by Stanford University Institutional Review Board (approval No. 46691).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Nouf Akeel, MD, Associate Professor, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Idara S, Jeddah 21589, Makkah al Mukarramah, Saudi Arabia.
nakeel@kau.edu.sa
Received: September 22, 2025
Revised: October 30, 2025
Accepted: December 1, 2025
Published online: January 27, 2026
Processing time: 124 Days and 10.6 Hours
BACKGROUND
The perception of symptoms in individuals with rectal prolapse (RP) can be influenced by psychiatric disorders (PD). It was hypothesized that women with a history of PD would experience higher levels of bother from RP symptoms.
AIM
To examine the relationship between PD and symptom severity in women with RP.
METHODS
A retrospective analysis was conducted on female patients with RP from an approved registry. Demographic data, medical history, and prolapse-associated symptoms were collected. Validated questionnaires were used to measure the severity of symptoms and degree of associated bother. Patients with and without psychiatric history were compared.
RESULTS
Among the 200 patients included in the study, 83 (42%) had a PD, with depression (n = 46) and anxiety (n = 38) being the most prevalent. Patients with psychiatric history were younger (mean age: 58 ± 16) compared to those without PD (mean age: 66 ± 15; P < 0.001). The patients with PD reported higher scores on the Pelvic Floor Distress Inventory Questionnaire-20 [median (interquartile range): 137.5 (77.08, 180.21) vs 101.04 (67.71, 150)] and Pelvic Floor Impact Questionnaire-7 [median (interquartile range): 100 (59.52, 171.43) vs 80.95 (38.10, 142.86)]. The bowel symptoms were the primary contributors to the distress experienced by these patients.
CONCLUSION
Women with RP have a higher prevalence of PD and perceive bowel symptoms as more severe. Routine screening for PD is recommended and may improve patients’ outcomes.
Core Tip: The prevalence of coexisting psychiatric disorders in women with rectal prolapse is 42%. These patients were younger and had higher rates of chronic constipation. The Pelvic Floor Distress Inventory Questionnaire-20 and the Pelvic Floor Impact Questionnaire-7 revealed greater symptom distress and a more significant impact on quality of life in this group. The bowel symptoms were the main contributors to the distress experienced by these patients. This study supports the importance of screening for psychiatric conditions in rectal prolapse patients, which may improve individualized care.
