An enterocele, or small bowel prolapse, is a type of pelvic organ prolapse. It occurs when the small intestine prolapses, or drops, causing a bulge in the vagina. Postmenopausal women and women who have given birth are more likely to develop enteroceles. Pessary devices and Kegels (pelvic floor exercises) can help.
An enterocele (EN-ter-uh-seel) occurs when part of the small intestine drops (prolapses) into the pelvic area. The small intestine (or small bowel) pushes against the top of the vagina, causing a bulge. Another name for enterocele is small bowel prolapse. It’s a type of pelvic organ prolapse that affects the female reproductive system.
Approximately 3% to 6% of women in the United States experience some type of pelvic organ prolapse. It most commonly affects postmenopausal women who are white or Hispanic.
An enterocele occurs when muscles, connective tissues and ligaments in the pelvic region (pelvic floor) stretch or tear. These muscles and tissues support the bowels, uterus and vagina.
The small intestine is part of the digestive system. Typically, muscles and ligaments hold the small intestine in the lower abdomen (belly) and upper pelvis. Weak tissues allow the organ to slip lower into the pelvic area between the vagina and rectum. The small intestine then presses against the upper wall of the vagina.
An enterocele, or small bowel prolapse, may occur along with other pelvic organ prolapses, such as:
Your risk of developing an enterocele increases during and after menopause when estrogen levels drop. Estrogen helps keep pelvic muscles strong. More than 1 in 3 women with pelvic floor disorders like enteroceles are between 60 and 79 years old. About half are older than 80.
Other conditions that weaken pelvic floor muscles and cause enteroceles include:
Some women don’t have symptoms. When symptoms occur, they may include:
You may find out you have an enterocele when your healthcare provider performs a pelvic exam. Your provider can feel the bulge caused by the intestine pressing into your vagina. Your provider may ask you to cough or press down during the exam so they can feel the bulge. They may also perform a rectal examination.
You may also get one or more of these tests:
There are nonsurgical and surgical treatments for enteroceles. Your healthcare provider can discuss treatment options with you. Your age, overall health and symptoms may determine the best treatment.
Treatments for an enterocele include:
Nonsurgical treatments often relieve enterocele symptoms. Some women who aren’t having problems don’t need any treatment. An enterocele rarely causes serious problems.
You should call your healthcare provider if you experience:
You may want to ask your healthcare provider:
A note from Cleveland Clinic
Postmenopausal women and those who have given birth are most at risk of developing an enterocele or small bowel prolapse. Many women don’t have symptoms and don’t need treatment. If the prolapse causes problems, your healthcare provider can discuss treatment options. Most women get symptom relief through nonsurgical treatments. You may learn how to do pelvic floor exercises (Kegels) or use a removable support device called a pessary. Rarely, a woman needs surgery.
Last reviewed by a Cleveland Clinic medical professional on 08/11/2021.
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