Rectal prolapse
The term rectum or rectum refers to the lowest part of the large intestine with a length of 12-15 cm.
Normally, the rectum is firmly attached to the pelvis with the help of tendons and muscles and does not allow for a change of position.
Various factors, such as chronic constipation and the stress of childbirth, can cause the tendons and muscles to loosen and weaken, and as a result the rectum is not as firmly attached to the pelvis and the likelihood of its location changing increases .
Rectal prolapse, which means slipping or falling out of place, is possible. Sometimes large hemorrhoidal veins inside the rectum can be a predisposing factor for rectal prolapse.
What are the symptoms?
The clinical manifestations are similar to those of hemorrhoids, but the prolapse originates in a higher part of the colon.
Those affected may feel distraction of tissue from the anus and experience the following symptoms:
• Pain during defecation;
• Mucus or discharge of mucus or blood from the protruding tissue;
• Faecal incontinence – becoming unable to control the emptying of the rectum;
• Loss a desire to defecate, especially in people with larger prolapses;
• Sensation of a foreign body or something protruding when wiping;
Initially, the protrusion may appear with a bowel movement and retract afterwards. Subsequently, it may start to appear more often, for example, when coughing or sneezing.
Over time, the rectum may need to be manually retracted into the anus or continuously fed.
People with internal intussusception, in which the rectum is displaced but does not protrude outside the body, often experience difficulty with bowel movements and a feeling of incomplete defecation.
What are the causes?
Rectal prolapse is caused by weakening of the muscles and tendons that hold it in place and prevent it from moving. In most of those affected, the muscles of the anal sphincter are weak.
The exact cause of this weakening is unknown, but rectal prolapse is commonly associated with the following diseases and conditions:
• Advancing age;
• Chronic constipation or diarrhea;
• Constant straining during defecation;
• Pregnancy and childbirth stress;
• Previous surgical intervention;
• Cystic fibrosis;
• Chronic obstructive pulmonary disease – COPD;
• Whooping cough;
• Multiple sclerosis;
• Paralysis /paraplegia/;
Chronic hemorrhoidal disease is often associated with mucosal prolapse, but does not fully progress to rectal.
Treatment of rectal prolapse
In infants and children, reducing the need to strain during defecation by using stool softeners may correct the prolapse.
Applying a band-aid to the child’s bottom between bowel movements may resolve the problem of prolapsed rectum. But you should consult your personal doctor before any attempt at home treatment.
Medications to reduce pain and avoid straining that you can use are docusate sodium or calcium.
Prevention
A diet consisting of foods high in fiber and plenty of fluids may reduce the risk of constipation.
Straining during bowel movements should be avoided. People with chronic diarrhea, constipation, hemorrhoids should seek medical attention for treatment of these medical conditions to limit the risk of rectal prolapse.
