The rectum is the lowest part of the human digestive tract. It may slip out of its actual position and drop further down. The rectum then tends to hang out through the anal opening. It looks like a small reddish, fleshy mass protruding out of the anus. This condition is not dangerous, but it makes bowel movements very troublesome. It is more common in elderly women above the age of 50.
About rectal prolapse
When your rectum slips out of its normal position and hangs out of your anus, this condition is called rectal prolapse. It may seem awkward but not considered an emergency, as this condition does not interfere with digestion or other body functions. However, it should not be neglected for a long time, as it can cause complications.
There are three varieties of this prolapse. External prolapse occurs when the entire rectum hangs out of the anal opening. Mucosal prolapse occurs when only some parts of the rectal outer wall are visible out of the anus. Moreover, if the rectum slips off its position but has not protruded out of the anus yet, this condition is called internal prolapse.
Symptoms of rectal prolapse
- The feeling of something trying to bulge out of the anus, mainly during the bowel movement
- A small, red mass is noticed hanging out of the anus, which can be pushed back by hand.
- Continuous pain in the rectum and anus
- Traces of blood or mucus in the feces, due to bleeding from the rectum.
- Fecal incontinence (inability to control bowel movements)
- Constipation or diarrhea
- Feeling that your rectum isn’t empty after a bowel movement
Causes of rectal prolapse
- Prolonged diarrhea or severe constipation for many years
- Too much pressure is exerted for bowel movements
- Weakening of the supporting ligaments and muscles due to old age
- A severe injury to the pelvic region that extended to the rectum
- Multiple pregnancies and vaginal childbirth can damage the nerve responsible for muscle contraction
- Injury or disease in the spinal cord causes damage to related nerves.
When to see a doctor
You might have to consult a doctor if you feel any of the symptoms of rectal prolapse. It will be more painful and uncomfortable for you if it is neglected for too long. Also, there may be the risks of other complications arising due to this medical condition.
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Treatment of rectal prolapse
Your doctor may conduct a simple clinical test to diagnose the prolapse of your rectum. Advanced diagnostic tests like ultrasound, anal electromyography, colonoscopy, anal manometry, proctography, and MRI scan can also be suggested to diagnose the condition.
Surgery is the only way of treating this medical condition. There are two types of surgery that can be conducted for the treatment of rectal prolapse.
- Abdominal surgery – This surgery is done by laparoscopy or with a larger incision on the abdomen. The rectum is fixed back into its original place, which is called rectopexy. Using a mesh sling or sutures, he/she anchors the rectum to the sacrum (back wall of the pelvis). A part of the intestine can also be removed before conducting the rectopexy.
- Perineal rectosigmoidectomy (rectal prolapse repair through the area around anus): During a more commonly performed Altemeier procedure, surgeon pulls out the rectum through anus, removes a part of the rectum and sigmoid, and attaches the remaining rectum to the colon (large intestine).
- Delorme procedure, another technique of repairing rectal prolapse through the perineum, is done more typically for short prolapses. The lining of rectum is removed and the muscular layer is folded to shorten the rectum.
For many individuals, rectal prolapse surgery relieves symptoms and improves constipation and fecal incontinence. If you have constipation before surgery, talk to your doctor about ways to relieve it.
Frequently Asked Questions (FAQs)
- Is there any risk in surgery for curing rectal prolapse?
Healing may take longer for the point where two ends of the digestive tract are stitched together. Bleeding may occur from the rectum even after the surgery. It may be tougher to pass out the feces, leading to constipation or even incontinence of stool. The rectum may prolapse again.
- What is the success rate of the surgery to cure prolapse of the rectum?
The success of rectal prolapse surgery depends on the age and the health condition of the patient. Abdominal surgery is more successful in preventing the further prolapse of the rectum than other methods.
- How long will I need to recover from the rectal prolapse surgery?
Normally, a patient needs to stay for 2 – 3 days in the hospital for observation after the prolapse surgery. However, he/she can fully recover within a month. But the patient should not do any vigorous physical work within six months of this surgery.