About Rectal Prolapse
Rectal prolapse is a medical condition in which the rectum, which is the last part of the large intestine, pushes through the anus. It can occur in two forms:
- Complete rectal prolapse: The entire wall of the rectum drops through the anus.
- Partial rectal prolapse: Only the lining of the rectum drops through the anus.
Rectal prolapse is different from hemorrhoids, which are swollen veins around the rectum and anus. It can range from mild to severe, with symptoms such as pain, bleeding, and fecal incontinence. Women over the age of 50 are more likely to have this condition compared to men. Mild cases can often be treated without surgery, while severe cases may require surgical intervention. It's important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment options.
The causes of rectal prolapse include:
- Structural defects: Certain defects in the pelvis or lower gastrointestinal tract can increase the chance of rectal prolapse. These defects may cause or worsen rectal prolapse, such as a rectum that is not fixed in place or weak pelvic floor muscles.
- Differences in rectal structure: In children with rectal prolapse, there may be differences in the structure of the rectum, such as a straight, vertical position instead of the usual curve.
Non-modifiable risk factors of rectal prolapse cannot be changed or controlled. These include:
- Age: Rectal prolapse is more common in adults, particularly females aged 50 years or older.
- Race: White race has been identified as a non-modifiable risk factor for rectal prolapse.
- Personal and familial history: Having a personal or familial history of genital prolapse or pelvic surgery increases the risk.
Modifiable risk factors of rectal prolapse can be influenced or changed. These include:
- Obesity: Being overweight or having a high body mass index (BMI) increases the risk.
- Vaginal delivery and parity: Giving birth vaginally and having multiple pregnancies can weaken the pelvic floor muscles.
- Smoking: Smoking has been identified as a modifiable risk factor for rectal prolapse.
- Chronic constipation: Straining during bowel movements due to chronic constipation can make the rectum more likely to move down from its location.
Remember, it's important to consult with your healthcare professional for personalized advice and guidance.
The most common early symptoms of rectal prolapse include:
- Feeling of a bulge at the anus
- Reddish-colored mass protruding from the anus
- Sensation of sitting on a ball
- Rectal pressure and discomfort
- Bleeding from the rectum
As rectal prolapse progresses or becomes more severe, additional symptoms may occur, such as:
- Difficulty controlling bowel movements (incontinence)
- Chronic constipation or diarrhea
- Mucous discharge
- Bright red blood from the rectum
In more advanced cases or with complications, the following symptoms may be present:
- Strangulated prolapse: when part of the rectum becomes trapped and loses its blood supply, causing tissue death (gangrene)
- Solitary rectal ulcer syndrome: ulcers can develop on the protruding part of the rectum.
It's important to seek medical attention if you experience any symptoms of rectal prolapse, as treatment can help prevent worsening symptoms and complications.
To diagnose rectal prolapse, doctors may perform the following examinations, tests, and procedures:
- Medical history and symptom evaluation: Your doctor will ask about your medical history and symptoms related to rectal prolapse.
- Physical examination: Your doctor will conduct a physical examination, which may involve observing your anus while squatting or bearing down.
- Digital rectal exam: This procedure involves your doctor inserting a finger into your rectum to assess the health and strength of the anal sphincter and rectum.
Additional examinations, tests, and procedures to determine the severity of rectal prolapse may include:
- Defecography: This X-ray test, also known as proctography, shows the rectum and anal canal during a bowel movement.
- Colonoscopy: A long, flexible tube-like camera called a colonoscope is inserted to examine the large intestine and rectum in detail.
- Anorectal manometry: This test measures how well the muscles that control bowel movements are functioning by placing a pressure-measuring tube inside the rectum.
- Endoanal ultrasound: Using a thin ultrasound probe, the doctor examines the muscles involved in bowel control.
It's important to consult with your healthcare professional for specific recommendations as they can tailor diagnostic tests based on individual circumstances.
The goals of treatment for rectal prolapse are to restore the anatomy and physiology, improve continence, improve bowel function, and reduce the incidence of recurrence with lower morbidity and mortality. Here are various treatment options and how they work to achieve these goals:
- Medications: There are no specific medications for rectal prolapse. However, medications may be prescribed to manage symptoms such as constipation or diarrhea, which can contribute to the development or recurrence of rectal prolapse. These medications can help regulate bowel movements.
- Therapies: Physical therapy may be recommended to strengthen the pelvic floor muscles and improve bowel control. Biofeedback therapy can also be used to retrain the muscles involved in bowel movements.
- Therapeutic procedures: Surgical procedures are often used to treat rectal prolapse. The most common surgical options include laparoscopic resection rectopexy and laparoscopic suture rectopexy without resection. These procedures involve mobilizing and fixing the rectum in position to prevent further prolapse.
- Self-care and health behavior changes: Making certain lifestyle changes can help manage rectal prolapse. These include:
- Maintaining a healthy weight
- Eating a high-fiber diet to prevent constipation
- Avoiding straining during bowel movements
- Practicing good toilet habits, such as a regular schedule.
It's important to note that treatment options may vary depending on the severity of the condition and individual patient factors. It is best to consult with a healthcare professional for personalized advice.
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.