Rectal Prolapse: Causes, Symptoms, and Treatment Options

Understanding the etiology?

Hello: Please tell me what is rectal prolapse? How does it occur? How is it treated? Thank you.

Lian, 30~39 year old female. Ask Date: 2001/01/02

Dr. Wang Qichao reply Surgery

Generally speaking, the term "prolapse" is commonly used to refer to hemorrhoidal prolapse, but it is important to distinguish it from rectal prolapse.
Hemorrhoids, more appropriately referred to as anal cushions, serve to protect the anal canal during defecation and assist the anal sphincter in maintaining closure when at rest.
When the anal cushions become repeatedly inflamed and congested, leading to a loss of elasticity in their supportive fibers, they may protrude outside the anus during defecation or straining.
Severe prolapse (such as when manual reduction is required or when it becomes incarcerated) typically necessitates surgical intervention.
Mild prolapse may be treated with simple rubber band ligation or injection therapy.
In contrast, rectal prolapse involves the rectum protruding outside the anus and has a more complex etiology, often resulting from chronic straining during bowel movements, which can cause rectal intussusception.
Surgical treatment is usually required for this condition as well.

Reply Date: 2001/01/02

More Info

Rectal prolapse, also known as rectal prolapse syndrome, is a condition where the rectum, the final section of the large intestine, protrudes through the anus. This can occur partially or completely, and it can be quite distressing for those affected. Understanding the causes, symptoms, and treatment options for rectal prolapse is essential for managing this condition effectively.

Causes of Rectal Prolapse
Rectal prolapse can result from a variety of factors, including:
1. Weakness of the Pelvic Floor Muscles: The pelvic floor muscles support the rectum and other pelvic organs. Over time, these muscles can weaken due to aging, childbirth, or chronic straining during bowel movements.

2. Chronic Constipation or Diarrhea: Frequent straining to pass hard stools or the urgency associated with diarrhea can put excessive pressure on the rectum, leading to prolapse.

3. Neurological Conditions: Conditions that affect nerve function, such as spinal cord injuries or multiple sclerosis, can impair the muscles that control bowel movements, contributing to prolapse.

4. Previous Surgery: Surgical procedures in the pelvic area, such as hysterectomy, can alter the support structures of the rectum.

5. Genetic Factors: Some individuals may have a hereditary predisposition to develop rectal prolapse due to connective tissue disorders.

Symptoms of Rectal Prolapse
The symptoms of rectal prolapse can vary in severity and may include:
- A visible protrusion of the rectum through the anus, especially during bowel movements or straining.

- Discomfort or pain in the rectal area.

- Bleeding or mucus discharge from the rectum.

- A feeling of incomplete bowel evacuation.

- Changes in bowel habits, such as constipation or fecal incontinence.

Treatment Options
Treatment for rectal prolapse depends on the severity of the condition and the patient's overall health. Options include:
1. Conservative Management: For mild cases, dietary changes to increase fiber intake, along with stool softeners, can help alleviate constipation and reduce straining. Pelvic floor exercises, such as Kegel exercises, may also strengthen the supporting muscles.

2. Surgical Intervention: In more severe cases, surgery is often necessary to repair the prolapse. There are several surgical techniques, including:
- Rectopexy: This procedure involves attaching the rectum to the surrounding tissues to provide support.

- Resection: In some cases, a portion of the rectum may be removed, especially if there are complications such as rectal ulcers or significant damage.

- Perineal Procedures: These involve accessing the rectum through the perineum (the area between the anus and the genitals) and may be suitable for older patients or those with significant health issues.

3. Follow-Up Care: After treatment, regular follow-up with a healthcare provider is crucial to monitor for recurrence and manage any ongoing symptoms.

Conclusion
Rectal prolapse is a manageable condition, but it can significantly impact a person's quality of life. If you suspect you have rectal prolapse or are experiencing symptoms, it is essential to consult a healthcare provider for a thorough evaluation and appropriate treatment. Early intervention can lead to better outcomes and improved quality of life.

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