About Small Bowel Prolapse
The causes of small bowel prolapse are not fully understood, but it is believed to be a result of weakened pelvic floor muscles and ligaments that support the organs in the pelvis.
Non-modifiable risk factors are risk factors that cannot be changed. Non-modifiable risk factors for small bowel prolapse include:
- Age: The risk increases with age, especially after menopause.
- Race: White individuals have a higher risk compared to other races.
- Menopause: Hormonal changes during menopause can weaken pelvic floor muscles.
Modifiable risk factors are risk factors that can be changed or influenced. Modifiable risk factors for small bowel prolapse include:
- Obesity: Excess weight puts pressure on the pelvic floor muscles.
- Smoking: Smoking can weaken connective tissues, including those supporting the pelvic organs.
- Vaginal delivery and childbirth: The stretching and trauma during childbirth can weaken the pelvic floor muscles.
- Chronic constipation: Straining during bowel movements can contribute to pelvic floor muscle weakness.
It's important to note that these risk factors may increase the likelihood of developing small bowel prolapse, but they do not guarantee its occurrence. If you suspect you have small bowel prolapse, it's best to consult with your healthcare professional for an accurate diagnosis and appropriate treatment options.
The most common early symptoms of small bowel prolapse include:
- Cramping abdominal pain that comes in intense waves
- Nausea and vomiting
- Bloating of the abdomen
- Rapid pulse and breathing during cramps
As the condition progresses or reaches higher severity, additional symptoms may occur, such as:
- Intermittent bouts of constipation for several months beforehand
- History of rectal bleeding (such as streaks of blood on the stool)
- Diarrhea resulting from liquid stool leaking
It's important to note that symptoms can vary from person to person, and not everyone may experience all of these symptoms. If you suspect you have small bowel prolapse, it's best to consult with your healthcare professional for an accurate diagnosis and appropriate treatment.
To diagnose small bowel prolapse, doctors may perform the following examinations, tests, and procedures:
- Medical history review: The doctor will ask about your symptoms and medical history.
- Physical examination: The doctor will conduct a physical examination to assess the pelvic area. The doctor may examine the pelvic area to assess the degree of prolapse using techniques like forceful downward breath-holding or abdominal pressure.
- Routine blood and urine tests: These tests help assess the overall health and rule out other conditions.
- Coagulation series: This test checks the blood's ability to clot properly.
- Lab test and cultures: These tests evaluate the presence of any infections that may contribute to the condition.
- Chest X-ray: It helps determine the condition of important organs for an accurate diagnosis.
- Urological ultrasound: This test may be performed to rule out any anal or rectal lesions.
Remember, these are general descriptions of examinations, tests, and procedures. The specific tests and procedures may vary depending on individual circumstances. It is important to consult with your healthcare professional for personalized advice.
For some people, small bowel prolapse doesn’t cause bothersome symptoms. In these cases, the small bowel prolapse may not need to be treated other than with exercises and avoiding heavy lifting or straining.
For symptomatic or more advanced small bowel prolapse, the goals of treatment include:
- Providing symptom relief
- Strengthening the pelvic floor to prevent recurrent
- Improve the absorption capacity of the remaining small bowel, which means maintaining normal growth and hydration without the need for parenteral support (referring to the administration of medications or nutrition directly into the body, often through injection or infusion) for more than three consecutive months.
To achieve these treatment goals, the following approaches may be recommended:
- Pessary: A pessary is a small latex or silicone device. The pessary is inserted into the vagina where it helps support the bulging tissue of the prolapse. The healthcare professional measures and fits this the person with the right size device. The pessary should be removed and cleaned with soap and water nightly or weekly as advised by the doctor.
- Physical therapy: Kegels exercises are a type of pelvic floor exercises that help strengthen the pelvic floor muscles. A physical therapist may help you learn to strengthening the pelvic floor muscles prevent further prolapse and reduce symptom.
- Medications: There are no specific medications for small bowel prolapse. However, medications may be prescribed to manage symptoms such as diarrhea, bladder control problems or gastric hypersecretion. Ask your doctor about appropriate medications for your individual situation.
- Surgery: Surgical intervention may be necessary in some cases to repair or reinforce the weakened pelvic floor muscles and move the small bowel back into place. The surgery potentially may be performed using a minimally invasive approach using special tools through the vagina.
- Health behavior changes to help prevent worsening of symptoms and reduce the risk of recurrence.
- Maintain a healthy weight
- Avoiding heavy lifting
- Practice good bowel habits: Avoid straining during bowel movements to help prevent worsening of symptoms and reduce the risk of recurrence.
- Stay hydrated and include fiber in the diet to help prevent constipation.
- Quit smoking
- Treat chronic coughs
It's important to note that treatment approaches may vary depending on individual circumstances. Consult with your healthcare professional to determine the most appropriate treatment plan for you.