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SHIV SHAKTI PILES CLINIC

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Dr. Deepak R. Shrivastav (M.B.B.S) (A.M), M.D.(A.M).

Prolapse Of Rectum

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Rectal prolapse occurs when part or all of the wall of the rectum slides out of place, sometimes sticking out of the anus.

TYPES OF PROLAPSE

1. Partial prolapse (also called mucosal prolapse). The lining (mucous membrane) of the rectum slides out of place and usually sticks out of the anus. This can happen when you strain to have a bowel movement. Partial prolapse is most common in children younger than 2 years.

2. Complete prolapse. The entire wall of the rectum slides out of place and usually sticks out of the anus. At first, this may occur only during bowel movements. Eventually, it may occur when you stand or walk. And in some cases, the prolapsed tissue may remain outside your body all the time.

3. Internal prolapse (intussusception). One part of the wall of the large intestine (colon) or rectum may slide into or over another part, like the folding parts of a toy telescope. The rectum does not stick out of the anus. Intussusception is most common in children and rarely affects adults. In children, the cause is usually not known. In adults, it is usually related to another intestinal problem, such as a growth of tissue in the wall of the intestines (such as a polyp or tumour).

Causes


Many things increase the chance of developing rectal prolapse. Risk factors for children include:

1. Cystic fibrosis. A child who has rectal prolapse with no obvious cause may need to be tested for cystic fibrosis.

2. Having had surgery on the anus as an infant.

3. Malnutrition is the condition that develops when the body does not get theright amount of the  vitamins, minerals, and other nutrients it needs to maintain healthy tissues and organ function.

4. Deformities or physical development problems.

5. Straining during bowel movements.

6. Infections.

7. Risk factors for adults include.

8. Straining during bowel movements because of constipation.

9. Tissue damage caused by surgery or childbirth.

10. Weakness of pelvic floor muscles that occurs naturally with age.

The first symptoms of rectal prolapse may be:


1. Leakage of stool from the anus (faecal incontinence).

2. Leakage of mucus or blood from the anus (wet anus).

3. Loss of urge to defecate (mostly with larger prolapses)

4. A feeling of having full bowels and an urgent need to have a bowel movement.

5. Passage of many very small stools.

6. The feeling of not being able to empty the bowels completely.

7. Anal pain, itching, irritation, and bleeding.

8. Bright red tissue that sticks out of the anus.

Symptoms of a prolapsed rectum are similar to those of hemorrhoids; however, rectal prolapse originates higher in the body than hemorrhoids do. A person with a prolapsed rectum may feel tissue protruding from the anus and experience the following symptoms: Pain during bowel movements.

Several factors may contribute to the development of rectal prolapse. It may come from a lifelong habit of straining to have bowel movements or as a delayed result of stresses involved in childbirth. In rare cases, there may be a genetic predisposition in some families. It seems to be a part of the aging process in many patients who experience weakening of the ligaments that support the rectum inside the pelvis as well as loss of tightness of the anal sphincter muscle. In some cases, neurological problems, such as spinal cord transection or spinal cord disease, can lead to prolapse. In most cases, however, no single cause can be identified.

Prevention


Home treatment for adults may help treat the prolapse and may be tried before other types of treatments..

1. Avoid constipation. Drink plenty of water, and eat fruits, vegetables, and other foods that contain fiber. Changes in diet often are enough to improve or reverse a prolapse of the lining of the rectum (partial prolapse).

2. Do Kegel exercises to help strengthen the muscles of the pelvic area.

3. Don't strain while having a bowel movement. Use a stool softener See a doctor if you or your child has symptoms of rectal prolapse. If it is not treated, you may have more problems. For example, the leaking stool could get worse, or the rectum could be damaged.

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