What Is Rectal Prolapse?
Gastrointestinal pathologies, such as fecal incontinence and constipation, are very uncomfortable. As if that weren’t enough, they’re associated with different complications in the anorectal region. One of the problems is rectal prolapse, which decreases the quality of life.
Rectal prolapse is nothing more than the protrusion of the end part of the large intestine or rectum through the anal opening. This pathology occurs due to a disorder in the fixation of the rectum, which allows it to slide out of the body. Prolapse is more common in older people; it affects both sexes, although studies show that 90% of cases are in women.
The clinical manifestations reported by people with rectal prolapse are very similar to those of people with hemorrhoids. In this sense, it’s common to feel a slight bulge in the anal region, the size of which can vary.
The protrusion of the rectum through the anus isn’t usually painful, because the organ doesn’t have sensory innervation. However, it’s possible to have discomfort of varying degrees.
It has been shown that up to 75% of patients with this condition also have incontinence. Other symptoms may also occur:
- Anal itching
- Bleeding during defecation
- A feeling of incomplete emptying or rectal tenesmus
- Secretion of intestinal mucus through the anus
Causes of rectal prolapse
Rectal prolapses are linked to a large number of different conditions, so there’s no single cause. They usually appear as a complication of gastrointestinal diseases.
Generally speaking, a dysfunction in the muscles located in the pelvic floor is the cause. In addition to this, the fixation components of the rectum can be weakened.
One of the most important risk factors is pregnancy. The growth of the baby in the womb increases the pressure on the pelvic floor. This fact is what determines that women are the most prone to suffer from the condition.
Among other factors that predispose to rectal prolapse in adults, the following stand out:
- Chronic constipation
- Making great efforts when defecating
This condition can also appear in children. In them, the most frequent cause is usually a parasitic infection.
Specialists are able to diagnose rectal prolapse through a thorough history and physical examination of the anorectal region. During the interrogation, the doctor should inquire about underlying gastrointestinal pathologies, such as chronic constipation.
The physical examination is one of the most important diagnostic methods. It’s essential that a doctor inspects the area in order to evaluate the protrusion and differentiate it from a hemorrhoid. In some cases, it will be necessary to perform a Valsalva or stress maneuver to provoke the prolapse.
The digital rectal examination also provides important information to the doctor about the pathology, especially the state of a muscle called the internal sphincter of the anus. A colonoscopy may be indicated in order to confirm the presence of an adjacent intestinal pathology.
Rectal prolapse treatment
The most effective therapeutic option to treat rectal prolapse is to perform a surgical procedure. There are different techniques with a high success rate. However, the selection of the most appropriate will depend on the characteristics of each person.
The abdominal approach for the solution of this condition is the most used option due to a lower risk of recurrence. The rectum is mobilized and attached to the sacrum. Alternatively, the perineal operation is used when an abdominal approach isn’t possible and consists of the removal of the prolapsed segment.
The medical treatment of rectal prolapses is recommended for people who aren’t candidates for surgical procedures or who reject them. This therapeutic option is aimed at alleviating symptoms and improving the quality of life of those affected.
The main medical indications are to increase food intake to combat constipation. In this sense, the most recommended are foods rich in fiber, as well as soluble fiber dietary supplements. It’s also important to drink plenty of water during the day.
For young children affected by this condition, conservative treatment is very effective. In addition to eliminating the effort, the buttocks are usually attached with adhesive tape between each bowel movement, which favors the spontaneous resolution of the problem.
The best prevention is to eliminate effort
In summary, rectal prolapse is a rare condition in which a portion of the rectum protrudes through the anal opening. It usually appears as a complication of an adjacent pathology. The symptoms vary from the presence of a lump in the region to fecal incontinence.
Fortunately, it’s possible to prevent it. It’s simply necessary to eliminate any excessive effort made during defecation.
In this sense, carrying out the same measures mentioned regarding medical treatment is effective. It’s also possible to fix the disorder with a surgical procedure.