Rectocele: The Bulge That Affects Bowel Movements
SaveA rectocele is a bulge of the rectum into the back wall of the vagina. The classic symptom is trouble emptying stool, along with rectal pressure and a feeling that stool is trapped. Many women press on the vaginal wall to finish, a workaround called splinting. A pelvic exam confirms it.
Last updated: July 2026
What does a rectocele feel like?
A rectocele feels like pressure or fullness toward the back of the vagina, often strongest during a bowel movement. Women commonly describe stool that seems stuck, a bulge that appears when bearing down, and incomplete emptying even after a trip to the bathroom.
Splinting, or pressing a finger against the vaginal wall or perineum to help stool pass, is common but rarely mentioned to clinicians. A rectocele is a posterior-compartment prolapse and is part of the group of pelvic floor disorders affecting roughly 1 in 5 women, according to the Office on Women's Health 1Ref 1Office on Women's Health (U.S. HHS) (2025).Pelvic organ prolapse.Rectocele as a posterior-compartment prolapse, the 1 in 5 pelvic floor disorder figure, and childbirth and menopause as risk factors.. Mild rectoceles may cause no symptoms and turn up only on a routine exam 2Ref 2American College of Obstetricians and Gynecologists (2019).Pelvic Organ Prolapse: ACOG Practice Bulletin, Number 214.POP-Q staging of the posterior wall, centimeter thresholds relative to the hymen, peak rates at ages 70 to 79, and 13% lifetime surgery risk..
Why does a rectocele change bowel movements?
A rectocele changes bowel movements because stool can collect in the pocket the bulge creates instead of moving straight out. When you bear down, pressure pushes the rectal wall forward into the vagina rather than downward through the anus, so stool traps and emptying feels incomplete.
Chronic constipation and years of straining are common contributors, which is why easing constipation can reduce the bother even when the bulge remains. A Cochrane review reported that pelvic floor muscle training lowered the frequency and bother of bowel symptoms in one trial 3Ref 3Hagen S, Stark D (2011).Conservative prevention and management of pelvic organ prolapse in women.Evidence that pelvic floor muscle training reduced the frequency and bother of bowel symptoms in a prolapse trial.. Straining also tends to worsen over time, so bowel habits matter as much as the anatomy.
How is a rectocele different from constipation?
A rectocele and ordinary constipation can feel similar, but the trapping sensation of a rectocele has a mechanical cause. With simple constipation, stool is hard or infrequent; with a rectocele, stool may be soft yet still hard to pass because it lodges in the forward bulge.
A telltale sign is needing to splint, pressing on the vaginal wall, to complete a bowel movement, which points to anatomy rather than stool consistency alone 1Ref 1Office on Women's Health (U.S. HHS) (2025).Pelvic organ prolapse.Rectocele as a posterior-compartment prolapse, the 1 in 5 pelvic floor disorder figure, and childbirth and menopause as risk factors.. Rectoceles also often occur alongside a dropped bladder or other prolapse, so mixed symptoms are common. According to ACOG, staging on exam clarifies how far the posterior wall has descended, from 1 cm above the opening to well beyond it 2Ref 2American College of Obstetricians and Gynecologists (2019).Pelvic Organ Prolapse: ACOG Practice Bulletin, Number 214.POP-Q staging of the posterior wall, centimeter thresholds relative to the hymen, peak rates at ages 70 to 79, and 13% lifetime surgery risk..
How is a rectocele diagnosed and graded?
A rectocele is diagnosed with a pelvic exam and, occasionally, a defecography study when symptoms are severe. A clinician asks you to bear down and measures how far the back vaginal wall descends, staging it from 0 to 4 on the POP-Q scale 2Ref 2American College of Obstetricians and Gynecologists (2019).Pelvic Organ Prolapse: ACOG Practice Bulletin, Number 214.POP-Q staging of the posterior wall, centimeter thresholds relative to the hymen, peak rates at ages 70 to 79, and 13% lifetime surgery risk.. Stage 2, where the bulge reaches within 1 cm of the vaginal opening, is often when women first notice trapping 2Ref 2American College of Obstetricians and Gynecologists (2019).Pelvic Organ Prolapse: ACOG Practice Bulletin, Number 214.POP-Q staging of the posterior wall, centimeter thresholds relative to the hymen, peak rates at ages 70 to 79, and 13% lifetime surgery risk..
Prolapse is uncommon before childbirth and grows more likely after vaginal deliveries and across the menopause transition, when thinning tissue offers less support 1Ref 1Office on Women's Health (U.S. HHS) (2025).Pelvic organ prolapse.Rectocele as a posterior-compartment prolapse, the 1 in 5 pelvic floor disorder figure, and childbirth and menopause as risk factors.. According to ACOG, peak rates appear in women aged 70 to 79, though symptoms can begin decades earlier 2Ref 2American College of Obstetricians and Gynecologists (2019).Pelvic Organ Prolapse: ACOG Practice Bulletin, Number 214.POP-Q staging of the posterior wall, centimeter thresholds relative to the hymen, peak rates at ages 70 to 79, and 13% lifetime surgery risk..
When a rectocele needs a specialist
A rectocele deserves a visit when bowel symptoms, pressure, or splinting affect daily comfort. A gynecologist or urogynecologist can confirm the diagnosis, separate it from other causes of constipation, and review options from pelvic floor physical therapy and stool-softening habits to a pessary or surgery.
About 13% of women eventually have prolapse surgery, but many manage bowel symptoms with conservative care, according to ACOG 2Ref 2American College of Obstetricians and Gynecologists (2019).Pelvic Organ Prolapse: ACOG Practice Bulletin, Number 214.POP-Q staging of the posterior wall, centimeter thresholds relative to the hymen, peak rates at ages 70 to 79, and 13% lifetime surgery risk.. Mild, comfortable rectoceles are often watched, while worsening trapping or the need to splint every time is a reasonable reason to seek review. Gale can help you describe the pattern clearly before your appointment.
Common questions
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When rectocele symptoms need review
- —Inability to pass stool, severe rectal pain, or rectal bleeding is a reason to seek prompt clinician review.
- —A bulge you cannot push back, or tissue outside the body that becomes painful, discolored, or swollen, is a reason to seek same-day clinician review.
- —Needing to splint for every bowel movement, or trapping that keeps worsening, is a reason to seek a gynecology review.
- —New or unexplained changes in bowel habits are a reason to seek clinician review.
This article is general health education, not medical advice. Whether a rectocele needs monitoring, a pessary, or surgery depends on your exam, bowel symptoms, and preferences, and should be decided with a gynecologist or urogynecologist.
References
- 1.Office on Women's Health (U.S. HHS) (2025). Pelvic organ prolapse. Office on Women's Health (womenshealth.gov), U.S. HHS. link ✓Rectocele as a posterior-compartment prolapse, the 1 in 5 pelvic floor disorder figure, and childbirth and menopause as risk factors.
- 2.American College of Obstetricians and Gynecologists (2019). Pelvic Organ Prolapse: ACOG Practice Bulletin, Number 214. Obstetrics & Gynecology. doi:10.1097/AOG.0000000000003519 ✓POP-Q staging of the posterior wall, centimeter thresholds relative to the hymen, peak rates at ages 70 to 79, and 13% lifetime surgery risk.
- 3.Hagen S, Stark D (2011). Conservative prevention and management of pelvic organ prolapse in women. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD003882.pub4 ✓Evidence that pelvic floor muscle training reduced the frequency and bother of bowel symptoms in a prolapse trial.
3 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — every citation independently verified. Editorial policy