What is Rectal Prolapse?
Rectal prolapse is a condition in which the rectum or the grim dowry of the large intestine , protrudes out through the last part of the big bowel or the anus . Prolapse is dragging or slipping down of a part from its original place . In rectal prolapsus , the rectum begins to slip down from its office , through the anus . Rectal prolapse is usually visualise in older people and in those who have experience long term constipation and torture .
Rectal prolapse is also common in those suffer weakness of the pelvic floor muscles . While rectal prolapse can happen in jr. people too , older adult are also ordinarily seen having rectal prolapse . Also , womanhood are more potential to experience rectal prolapse than others .
In rectal prolapse , the walls of the rectum or the mucosa , protrude out through the anus . Depending on the degree of protrusion , rectal descensus is classified into further types of rectal prolapse . These admit :
Risk Factors of Rectal Prolapse
Rectal prolapse is normally noted in elderly woman , post - menopausal women and those with a account of pelvic floor impuissance , constipation or straining to run motions . Rectal prolapse is influenced by an gain in the intra - abdominal pressure , which is find out in condition like pregnancy , benign enlargement of prostate , chronic cough , cystic fibrosis or pulmonary disorder with persistent sever coughing .
The commonest risk factors seen associated with rectal prolapse include chronic constipation , unsatisfactory passing of potty , tense up and constipation alternated withdiarrhea . Pelvic storey weakness conduce to rectal prolapsus may be determine in women who have had multiple speech but rectal prolapse has also been noted in young women who have never delivered a baby . People who have undergone previous surgical operation , who have experienced neurological disorder , trauma to the spine or gloomy back , spinal or lumbar phonograph recording problems and tumors of the spine can also be at an increase risk of rectal prolapse .
Younger child may also sometimes have rectal prolapse , but it may resolve by itself without any treatment . Rectal prolapsus seen in tike may be sometimes associated with disorders of the bowel or colon , rectal polyps , congenital megacolon , Hirschsprung ’s diseaseor condition of continuing cough .
Symptoms of Rectal Prolapse
While rectal prolapse often presents itself bit by bit , the main symptom usher is the swelling of great deal through the anus . Initially the mass may protrude or appear in the anus only on straining or when authorise motions and will mostly settle after passing motions or on standing . Gradually , in rectal descensus , the mountain may protrude on any strain , coughing or sneezing ; on performing activities that increase the intra - abdominal press .
Eventually in rectal descensus , the rectal mass may come up out of the anus even when stand , walk or when performing routine daily activities . This circumstance may advance , when rectal prolapse begin to touch the day-by-day life of a individual . When this condition of rectal prolapse continues , it may get more difficulty and the protrude plenty may have to be replaced manually .
These symptoms of protrusion of rectal passel in rectal descensus vary from person to person . In most shell , people experience as if some flock was settle out when the mass protrudes or as if they are sitting on a musket ball until the project hatful in rectal prolapsus is push back .
In summation to the good deal protrusion , rectal descensus also presents with several other symptom like :
Greater degrees of rectal prolapse may present with lack of urge to pass stools and a constant feeling of heaviness in the rectum . Rectal prolapse with internal prolapse or home introversion may show symptoms of difficulty in intestine movements . This often conduce to a wizard of incomplete bowel movements and unsatisfactory bowel headroom . Symptoms may sometimes also include a burning at the stake , itchy sensation at the anus with increase irritation in the area follow with bleeding .
Sometimes , the rectal mucous membrane , which is prolapse in rectal descensus can become thick and get ulcerated . This can produce severe pain and bleeding through the rectum and on uncommon social occasion , the rectal prolapse can get stuck up outside the anus , which may demand immediate medical attention .
Diagnosis of Rectal Prolapse
complaint associated with rectal prolapse may mimic other medical complaint as well , hence interpret the condition is indispensable . Diagnosis of rectal prolapse can be made by take a personal history , note story of previous ailments , past OR or hospitalization . Clinical examination of the local area or rectal scrutiny is important and it helps to unveil signs related to rectal prolapse . The physician may acknowledge a free stack of tissue stick around out of the rectum , which may be suggestive of rectal prolapse .
Contraction of anal retentive sphincter is also study . Advanced tryout may be done to note the excrescence of the rectal mass in rectal prolapse . Enema may be give to help the observation and confirm the diagnosis of rectal descensus .
Tests for rectal examen may be do to detect abnormalities in the heavy gut , rectum or anus and its correlation coefficient to possible rectal prolapse . These trial may include :
Proctography , in which scan of the rectum and anus can be get during a bowel movement . echography of the anal retentive region may be done to reckon the muscleman that control the intestine movement .
Some test facilitate to dominate out conditions like ulcer , tumour or other trouble blocking the intestinal passage leading to rectal prolapse . These tests include
Other tests may be arrange , if receive appropriate to discover out causes and conditions lead to rectal prolapse or to find out other ailments . These trial may be able to find abnormalities with the muscles , mettle or damage to any voiced tissue cause rectal prolapse . They may also help to happen any specific abnormalities in the Costa Rican colon including gastrointestinal and colon upset , polyps , tumors or Cancer .
Treatment for Rectal Prolapse
Treatment for rectal prolapsus depend on the condition , cause of rectal descensus and the age of the person .
The rough-cut crusade or condition leading to rectal prolapsus may be treat with medications . stultification is treat with laxatives and like medicines . Medicines that aid in better digestion may be given for some . Treating constipation and avoid straining when passing stools is important to manage rectal descensus . Manual chastisement of rectal prolapse may be tried by the physician and if necessary , may be repeated as appropriate . Soft supporting may be advised after manual correction of rectal prolapse .
Putting the prolapse rectal mass into original situation , must be done with MD ’s advice .
A diet that include fiber , fresh fruit and vegetables , salads , multigrain , etc . may be advised to abridge constipation and make gut movement more regular and smooth .
Drinking enough urine and fluids also helps and is commonly advised .
Regular exercise and strong-arm activity is also often commend to order bowel movements and also help in digestion . Therapeutic exercises may be prescribed to strengthen the abdominal muscles and structures of the pelvic floor . This is especially ask in people who have undergo previous surgery or legal transfer leading to rectal prolapse . Kegel exercisesare a great way to strengthen the muscles in the pelvic realm ; these are best performed with expert ’s guidance .
Those who have milder degrees of rectal prolapse , these management pourboire broadly speaking serve . For those with severe grade of rectal prolapse , sodding rectal prolapse or partial prolapse that does not reply to aesculapian treatment and dieting , may have to be considered for operative discussion of rectal prolapse .
Treatment for Rectal Prolapse in Children
In children , rectal prolapse may resolve without treatment in most suit ; however some nestling may require advanced treatment , depending on the rigorousness of the condition . This may include inject certain medicines that help to keep the rectal mucous membrane in shoes . In subject this treatment does not serve , operative correction may have to be deliberate in very few nipper .
Surgery for Rectal Prolapse
operating room for rectal prolapse may look on the severity of the term , geezerhood and the success of the late treatment given . Surgery for rectal descensus may be performed as an abdominal surgery or a perineal surgery , calculate on the condition . Possible options of surgical approaches include :
It is important to consider all options for treat rectal descensus and talk over possible side outcome of each subroutine with the treating physician . The most appropriate subprogram may be resolve reckon on the condition and the severity .
Prognosis of Rectal Prolapse
Rectal prolapse can be cure once the cause is treated ; surgical correction normally altogether bring around rectal prolapse . If rectal prolapse is left untreated , it may develop further ramification like stultification , loss of gut restraint . Also there are fortune that the jut rectal the great unwashed may remain prolapsed , can cause pain in the neck and can increase chances of bleeding and infection , if not treated in sentence . In kid , rectal prolapsus almost always gets cured after treating the cause .
