Surgical approaches in rectal prolapse can be either perineal or abdominal. Prolapse can refer to many different medical conditions other than rectal prolapse. Sphincter function in rectal prolapse is almost always reduced. Complications may include necrosis and ulcers of the rectal tissue. The prostate is enlarged and tender on digital rectal examination. Internal hemorrhoids often result in painless, bright red rectal bleeding when defecating. Levatorplasty is performed to correct elvator diastasis which is commonly associated with rectal prolapse. Physical exercise is associated with a modest reduction in colon but not rectal cancer risk. It is usually not necessary with obvious external rectal prolapse. Hemorrhoids are caused by swollen veins in the rectal area. Reported modalities of intake include oral consumption, insufflation, smoking, rectal and intravenous use. In full thickness rectal prolapse, these folds run circumferential. This means it can also be used to treat rectal and colon problems. Other adjacent structures can sometimes be seen in addition to the rectal prolapse. The hydrochloride salt is available for intramuscular, intravenous, rectal and oral administration.