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Prolapse of the rectum in medicine is called rectal prolapse. The disease develops gradually, but without treatment, a fragment of the intestine may fall out of the anus. Changes are often noticeable only after several years, or even decades. Many patients go to the doctor already in old age.
According to statistics, men suffer from rectal prolapse most often due to excessive loads, anatomical features. In women, the disease provokes stress during pregnancy and childbirth, stretching the muscles of the pelvic floor. But until the end, all the reasons have not yet been studied.
In itself, rectal prolapse is not life-threatening. But it brings a lot of discomfort and pain – in case of prolapse, a sharp tension of the mesentery is possible (with its help, the organs are attached to the back wall of the abdomen). This causes such pain that a state of shock is possible. The disease leads to the inability to retain gases and feces, requires periodic manual repositioning of the prolapsed intestine, which does not solve the problem. Complications of rectal prolapse can be life threatening. Therefore, it is important to diagnose the problem in time and start treatment.
What is rectal prolapse
In the first stages of rectal prolapse, there are only small protrusions in the anus during exercise. This can be mistakenly confused with hemorrhoids. Further, the muscles of the pelvic floor and the sphincter weaken more and more, and the rectum protrudes more.
Prolapse can be internal or in the form of invagination of the rectum. In this case, the section of the intestine sags, penetrates into the underlying intestine, but does not exit into the anus. There are almost always several causes of the disease, and their combination leads to such a condition.
Causes of rectal prolapse in adults
The specific causes of rectal prolapse are not known for certain. There are several reasons that clearly provoke rectal prolapse. But not always the presence of these causes leads to illness.
The main cause of the pathology is intestinal invagination, the introduction of one intestine into another. However, the disease is provoked by various features of the body: weak pelvic floor muscles, which stretch more and more under load, a weak sphincter. Also, anomalies in the structure of the uterus, sigmoid colon, sacrum.
These pathologies can be congenital, but can also be acquired during life. For example, as a result of multiple pregnancy, after childbirth, trauma to the perineum and anus. Anal sex also stretches the sphincter and pelvic floor muscles.
An increase in intra-abdominal pressure is bad for the health of the rectum. Increases pressure frequent coughing, heavy physical exertion.
Symptoms of rectal prolapse in adults
Symptoms vary depending on the stage of the disease. External rectal prolapse is quite easy to identify – it can be seen. With internal intussusception, patients experience pain, difficulty with defecation, blood and mucus appear.
Those suffering from rectal prolapse feel a foreign body in the anus, protrusion of the anus. Everything returns to normal after a bowel movement, but the discomfort persists for several hours.
Gradually, fecal incontinence, bleeding may develop, the intestine falls out more and more and requires repositioning by hands. This happens not only during bowel movements, but also during coughing and physical exertion. In severe cases, the intestine falls out already by 10 – 25 cm, it is difficult to set it. On the rectum, blood, dead areas are noticeable.
Treatment of rectal prolapse in adults
Treating rectal prolapse is most effective in the early stages. It is dangerous to delay going to the doctor, mistakenly interpret the disease as hemorrhoids and use folk methods.
The proctologist selects therapy after examination and questioning of the patient. Applied conservative and surgical treatment. The first can still normalize the condition if the disease is only developing.
Recommend a therapeutic diet, exercises for the muscles of the pelvic floor and sphincter. Avoid strenuous exercise. With constipation, they try to normalize the stool, use gentle laxatives. They are used only with the permission of a doctor, since the wrong selection of drugs can increase the load on the intestine and sphincter.
Also used sclerotherapy of the rectum. This makes sense when treating young people in the early stages of rectal prolapse. The introduction of a sclerosing drug into the fiber leads to partial scarring, and the rectum is better held.
If conservative treatment is no longer effective, only surgery remains.
Diagnostics
After examination and questioning by a proctologist, a special test is performed. The patient sits down and strains, as a result of which it is assessed whether the sphincter can hold the intestine and how much it comes out.
Next, an instrumental examination is carried out. Defectography is an x-ray that allows you to assess the condition of the pelvic area and muscle tone. Manometry measures sphincter tone.
No less important is a visual examination of the rectum using a camera – sigmoidoscopy and colonoscopy. During the study, a piece of tissue may be taken for analysis.
Modern treatments
In the later stages of rectal prolapse, surgery is effective. Doctors select the method of surgical treatment depending on the stage, cause of the disease, the patient’s condition.
All methods come down to fixing the rectum in the correct position and narrowing the anus or sphincter. The intestine is sutured with special sutures to the fixed parts of the organs – for example, to the sacrum. If the fallen area is dead, it is removed completely or partially.
The least traumatic operations prevent prolapse through the formation of muscle couplings, and other methods. The disadvantage of such operations is a high probability of recurrence. But for some patients, only minimally invasive surgery is possible.
Prevention of rectal prolapse in adults at home
Avoid constipation, prolonged straining during bowel movements. To do this, the diet includes coarse vegetable fibers, dairy products. They eat little and little. Avoid anything that can cause constipation and intestinal irritation – fatty, spicy, pickles, alcohol and coffee, soda, etc.
To strengthen the muscles of the pelvic floor and sphincter, special exercises are recommended. For example, “walking on the buttocks” on the floor in a sitting position.
Popular questions and answers
In order not to miss the disease, it is important to know what to avoid and when to immediately run to the doctor. Learn more about rectal prolapse proctologist and surgeon Vasyly Gavrilov.
With regards to complications, these are, as a rule, conditions that require urgent surgical intervention, and occur when patients seek medical help very late. It is possible to infringe on the prolapsed intestine, which, without medical help, leads to necrosis of the intestine. There is a risk of bleeding, ulcers.
The reason for calling a doctor at home may be a serious patient requiring home care. As well as an extremely neglected situation, brought to acute complications, such as acute intestinal obstruction. Unfortunately, this option can be fatal.
In all other cases, the situation requires planned surgical treatment, which today is the only one that can alleviate the patient’s condition.
It is also necessary to distinguish between two conditions: sitting in the toilet as a bad habit and spending a long time there due to chronic constipation and other bowel diseases. In the first case, the “social networks” syndrome can manifest itself in this way. Until a person watches all the news or just stays in silence, he does not go out, even if the “process” has already taken place at the very beginning.
To separate these causes, a thorough history taking, clarification of the details is required. Depending on the condition, and the correction will vary. In the case of sitting on the toilet “just because” sometimes a conversation is enough. In case of problems with the intestines, a diagnosis by a specialist is required.
Most likely, it is hormonal changes, the specificity of loads on the obturator apparatus during life, as well as the anatomy of the pelvic organs that affect the high prevalence of this condition in women. Gynecological reasons are also added here, for example, removal of the uterus, which men do not have.