Wondering if you have a rectal prolapse can leave you with feelings of anxiety. While a rectal prolapse is uncomfortable and can be worrying to think about, it rarely requires immediate medical attention. However, a prolapsed rectum is a condition that can go from mild to worse, and that can make a big difference when it comes to treatment options.
If you think you have a prolapsed rectum or want to know how to prevent getting one in the future, read on to find out about its causes, symptoms, treatments, and prevention tips. Being informed and prepared can take away some of that worry and can help protect you in the future.
What Is Rectal Prolapse?
A rectal prolapse (or anal prolapse) is a medical condition that occurs when the last part of the intestine, called the rectum, moves from its normal position and extends through the anus. It is not a very common condition with only 2.5 cases out of 100,000 people.
Rectal prolapse can vary from mild to severe. If it’s mild, mild cases may be treated without surgery, however, severe cases will probably require surgery to function properly.
If a woman’s rectum pushes through the thin wall between the anus and the vagina, it can cause a posterior vaginal prolapse, also called a rectocele.
What Causes Rectal Prolapse?
There are many things that can cause rectal prolapse:
Straining on the toilet
History of chronic diarrhea
History of chronic constipation
Weakened anal sphincter
Past hip or anal injury
Nerve damage
Old age
Diabetes
Chronic obstructive pulmonary disease
Hysterectomy
Women over 50 are six times more likely than men to experience a prolapsed rectum.
Rectal Prolapse Symptoms
If you have a prolapsed anus, it may feel you’re sitting on a ball or you may notice a new mass protruding out of your anus.
Other symptoms may include:
Rectal pain
Rectal bleeding
Mucus, blood, or stool leaking from the anus
Rectal prolapse is commonly mistaken for a severe form of hemorrhoids, and you would likely first notice it during or after a bowel movement.
Rectal Prolapse Treatment
Moderate-to-severe rectal prolapse may not heal on its own. It will probably get worse slowly over months or years. If left untreated, there may be some complications:
Lower blood supply in the rectum
Inability to push the rectum back in
Rectal damage or bleeding
Gangrene
Furthermore, unless it is mild enough for non-surgical treatment, the only way to treat a worsening case is with surgery.
There are different methods to perform surgery for rectal prolapse. Your doctor or surgeon will decide which way to address your case based on your health, the state of your condition, their experience, and their preference.
The two general approaches for rectal prolapse surgery are abdominal operations and perineal operations. Abdominal operations start on the belly and perineal operations start on the bottom. The aim of both types of procedures is to correct the rectal prolapse so that it doesn’t happen again.
There are three types of anesthesia your surgeon could give you for rectal prolapse surgery:
General anesthesia
Spinal block
Local anesthetic combined with intravenous drugs to promote relaxation
Abdominal Approach
These are the abdominal approaches to rectal prolapse surgery:
Abdominal Rectopexy with Possible Bowel Resection
Treating rectal prolapse with this method, the surgeon makes an incision in the lower abdomen. They then pull the rectum upwards and attach it to the back of the pelvic wall. Scarring will cause the rectum to attach permanently to the back of the pelvic wall. After using this method, 2-5% of cases relapse.
Sometimes the surgeon will remove part of the colon as well to improve function in those who have problems with constipation. You can expect to see positive results two to three months after they perform the procedure.
The surgeon may choose to do this laparoscopically, as a minimally invasive procedure. Instead of making a large incision, laparoscopic surgeries may employ robotics and tiny cameras through small incisions to put the rectum back into place.
Perineal Approaches
Perineal approaches for rectal prolapse have fewer complications, better pain management, and a shorter stay at the hospital. These are the perineal surgeries for correcting rectal prolapse:
Perineal Rectosigmoidectomy
In this procedure, there is no incision. Instead, the surgeon will cause the rectum to prolapse and then pull the excess colon out through the anus and remove it. Then they staple or sew it to the anus. Since they don’t make an incision, the healing time is shorter with this procedure, however, the rate of recurrence is higher than with the abdominal approaches.
Mucosal Sleeve Resection
The surgeon might occasionally decide to perform a mucosal sleeve resection when treating a rectal prolapse. It’s best performed on a smaller prolapse or when a full rectosigmoidectomy is difficult because the prolapse only occupies part of the circumference.
This procedure involves stripping and removing the inner lining of the rectum from the muscle. Then the surgeon folds the muscles and sews them to themselves, reducing the prolapse.
Complications from Surgery
Like with any other surgery, there may be complications. Although abdominal surgery yields better results, according to this study, abdominal surgery patients had a much higher incidence of infection and other complications. A high BMI and comorbid conditions can predict a higher risk of complications from abdominal surgery.
Other complications may include:
Infection at the incision site
Injury to nerves and blood vessels
Recurrence of rectal prolapse
Hemorrhage
Tissue necrosis
Allergic reaction to anesthesia
Rectal Prolapse Prevention
Prevention is always better than treatment, and there are things you can do to try to minimize your risk of experiencing rectal prolapse. Some things you can do to prevent this condition are:
Refrain from straining on the toilet
Drink six to eight glasses of water per day
Exercise regularly
Maintain a healthy weight
Resolve any identifiable source of problems with constipation or diarrhea
Avoid heavy lifting
Get enough fiber by eating at least five servings of fruit and vegetables a day
Contact
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