Background/Purpose: Rectal prolapse is a debilitating condition typically treated with surgery, yet some patients decline or are not candidates for operative intervention. Conservative management strategies are underreported, particularly in older adults. This case report describes the use of an integrative physical therapy approach, including pelvic floor muscle training, acupressure, and mindfulness-based interventions, in the nonsurgical management of rectal prolapse in an older adult. Case Description: A 71-year-old woman with chronic rectal prolapse, rectal and low back pain, urinary urgency, and functional limitations following bowel movements sought physical therapy after declining surgical intervention. Examination revealed pelvic floor muscle weakness, fascial restrictions, and symptom-related anxiety. A multimodal treatment plan included pelvic floor exercises, manual therapy, acupressure, breath training, and daily mindfulness practice. Outcomes: Over 7 visits, the patient reported a 90% reduction in prolapse severity based on self-rating. Rectal pain after bowel movements, rated 5/10 at baseline, was reduced to 0/10. Pelvic Floor Distress Inventory Questionnaire-20 scores improved from 220.83 to 84.28, exceeding the minimally important change threshold. She regained the ability to complete activities of daily living without post-defecation limitations and reported improved urinary control and functional mobility. Discussion: This case highlights the potential role of integrative physical therapy, including acupressure and mindfulness-based interventions, in the conservative management of rectal prolapse. The patient’s significant symptom relief and functional gains suggest that noninvasive, whole-person approaches may offer effective alternatives for select individuals. Further research is needed to evaluate implementation, outcomes, and standardization of these therapies in pelvic health rehabilitation.
Mehta et al. (Thu,) studied this question.