Dorothy FarrarRectal prolapse (prolapsed rectum)
A prolapsed rectum is an uncomfortable but rare condition. Older women are most often affected, especially if they have given birth to several children and suffer from pelvic floor weakness as a result.
What is a rectal prolapse?
In the case of a rectal prolapse (prolapsed rectum), the rectum turns its inner mucous membrane outwards, comparable to a sock that is turned inside out over the waistband. Depending on how far this incident extends, doctors distinguish three main degrees of severity:
- Stage 1: The rectal prolapse extends to the anal canal.
- Stage 2: The prolapse extends into the anal canal.
- Stage 3: The prolapse occurs through the sphincter to the outside.
causes
A prolapsed rectum can occur immediately after vigorous straining, heavy lifting, or sneezing, but sometimes spontaneously with no prior symptoms. The main cause, however, is chronic pelvic floor weakness , which occurs in older women after several births and can lead to a weakening of the sphincter muscle . But chronic constipation with heavy straining due to hard bowel movements or persistent diarrhea are also a strain on the sphincter muscle and can damage it in the long term and encourage an incident.
In very rare cases, rectal prolapse can also be congenital and occur in infancy when the rectum is not adequately attached to the pelvis. Other causes can be neurological diseases or dementia .
symptoms and course
Typical symptoms of rectal prolapse (prolapsed rectum):
The rectal prolapse usually begins slowly and unnoticed with a gradual detachment of the rectum tube from the holding apparatus of the intestine and initially does not cause any symptoms. Only when it comes to a minor incident, the first symptoms can appear. Mucous membrane folds or parts of the intestine can be felt on the anus, which can easily be pushed back again. These signs may be accompanied by uncomfortable itching in the anal region.
Symptoms only appear when the rectum sags and presses on the sphincter. Then symptoms similar to hemorrhoids occur, e.g. E.g. pain during bowel movements or the passage of blood or mucus due to friction of the mucous membrane. The increasing pressure weakens the sphincter muscle and incontinence problems occur , which are noticeable in the form of unwanted bowel movements or slight discoloration of the underwear.
Ulcers can also occur. If left untreated at this stage, the weakening of the sphincter muscle will eventually lead to a complete loss of control over bowel movements and the urge to defecate. To prevent this, medical treatment should be given as early as possible.
Diagnose
At the first sign of a rectal prolapse, you should see a doctor, preferably a proctologist. The doctor first asks about symptoms and any previously treated hemorrhoids. For women, he asks about the number of births and any incontinence problems. During the subsequent physical examination, an experienced doctor recognizes the rectal prolapse based on the visual diagnosis.
He then feels the rectum with his finger. A rectoscopy (scopy of the rectum) may be ordered to take a closer look at the intestinal mucosa and to send a tissue sample to the laboratory for examination. In more severe cases, a defecography, in which a contrast agent is injected, can be done to better assess the extent of the rectal apoptosis.
treatment and therapy
Most stages of a prolapsed rectum require medical treatment. If there are mild signs of chronic constipation, it may be enough to soften the stool with enemas or a high-fiber diet so that it can pass more easily and the disease is not aggravated by heavy straining. If necessary, the bowel movement can be supported with suitable medication. In milder cases, injections of active ingredients or sclerotherapy can also be carried out.
In most cases, however, those affected cannot avoid an operation. There are different procedures here. The surgeon can remove part of the rectum and reconnect the two ends. This procedure can be performed through the anus using the Altemeier method or through the stomach using the minimally invasive keyhole method. In this type of surgery, the bowel is fixed with a plastic mesh to prevent another prolapse.
In another method, only excess mucous membrane is removed via the anus, but the intestinal wall is preserved and the intestinal muscles are tightened with a special suture technique. This can improve incontinence problems due to the enlarged sphincter.
The surgical procedure depends on the symptoms and is decided individually. Before the procedure, the entire intestine is examined .
prevention
Since a rectal prolapse can be favored by chronic constipation, among other things, a diet rich in fiber and drinking enough is one of the best preventions. People with connective tissue weakness or pelvic floor weakness should not lift too heavily because of the risk of intestinal prolapse and should specifically train their pelvic floor and sphincter muscles. Anyone suffering from constipation, hemorrhoids or persistent diarrhea should seek medical treatment to have the causes clarified and to prevent aggravations.
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.