Rectal prolapse: causes, symptoms, treatment

Rectal prolapse affects a small number of patients, the problem is not common. However, in recent years, there has been a trend towards an increase in the disease. Rectal prolapse (this is the name of this disease) is not dangerous to life in itself, except for cases of collapse, but still it gives a lot of inconvenience to the patient. Therefore, everyone should be informed, know the symptoms of the disease, take timely measures for prevention and treatment.

Rectal prolapse is what?

With this disease, the lower part of the rectum, which is slightly above the anus, stretches, becomes mobile and at a pressure falls out. Falling is most often caused by a weak anal sphincter, which can result in the incontinence of mucus and feces. Pictures and photos of rectal prolapse indicate external manifestations of the disease - the rectum by its lower part extends beyond the canal.

The disease always delivers physical pain during defecation, psychological discomfort, characterized by incontinence of the sphincter (blood, mucus discharge). Rectal prolapse is dangerous for both children and adults.

With pathological changes, the lower part of the rectum stretches (its terminal zone), it is a visible area, which reaches up to 20 cm in length.

The disease is exhausting, difficult, although not life-threatening. Symptomatology reduces the quality of life, which affects the psyche of patients. In proctologic diseases rectal prolapse has a small percentage of the entire list of ailments. Diagnosis can be at any age, even in toddlers. It is noticed that in men this problem is revealed more often. Physicians are urged to take the necessary serious preventive measures.

Rectal prolapse: causes

The causes of the appearance of rectal prolapse are divided into two groups: producing and predisposing.

The first group (producing) includes the following:

• Regular straining of the rectum, for example, with frequent constipation;
• Complications during childbirth, when perineal ruptures were formed, as well as pelvic muscles;
• Operations performed on the intestine;
• Heavy physical work, when the muscular apparatus is constantly strained, intra-abdominal pressure rises;
• The sacral department is injured in some way;
• On the intestinal mucosa ulcers are formed.

There are other causes of rectal prolapse. Photos and pictures confirm the existence of anatomical features of a person. In these cases, predisposing causes arise:

• Pathology of pelvic muscles;
• Sphincter has low muscle tone;
• Increased intra-abdominal pressure;
• Deepening in the rectum;
• Stretching of the muscles of the intestine;
• Lengthening of the intestine, squam;
• The coccyx is located vertically;
• Complicated pregnancy, difficult childbirth.

Special attention is paid to physicians pathologies that arise in connection with non-traditional sexual preferences. The provoking factor of rectal prolapse may be permanent painful stimulation of the anus. As a result, not only pain, but also the prolapse of the rectum.

Types and stages

According to its typology, this disease has the following options:

• Falling is determined by the shifting down the front wall - this is a hernial version. Occurs with weak pelvic muscles, with increased intra-abdominal pressure. The mucous membrane of the rectum is squeezed and expelled outward.
• Inside the anal mucosa, there is an indentation of a part of the sigmoid or rectum, there is no withdrawal beyond the limits - this is an invagination option.

On the basis of the mechanisms of the development of the disease, proctologists distinguish the stages of the disease (degree) in rectal prolapse:

• Compensated minor stage. During defecation, there is a slight eversion of the intestine. At the end of the stool process, the gut itself comes to its original position.
• Subcompensated, deeper stage. The gut falls out, as in the first case, but returns to its initial position slowly, with pain syndromes and bleeding.
• Decompensated, tense stage. Rectal prolapse not only in the process of defecation, but also with any intra-abdominal pressure, tension, and the bowel does not self-adjust. Often there are bleeding, possibly incontinence of stool, gases. For a long time the sphincter is in a relaxed state.
• Decompensated deep, constant stage. At any physical exertion, in any position (sitting, standing), the intestine loses. Necrotic processes that develop on the mucosa cause bleeding, itching, and pain.

Symptoms and signs of the disease, complications

The development of the disease can occur at a slow pace, and can occur suddenly. More often prolapse develops gradually. At first, the prolapse of the intestine can be observed only during defecation. When the disease progresses, it is necessary to adjust the place, which falls out at any voltage.

Sudden fallout can trigger a sharp jump in intra-abdominal pressure in severe physical exertion. With a sudden dropout, severe pain occurs, which can cause a shock and even collapse.

Symptoms of rectal prolapse:

• There is a foreign body sensation in the anus;
• Frequent false urges to act of defecation;
• Constant pain in the anus;
• The possibility of containing feces and gases disappears.

When bowel prolapse, bleeding occurs, vessels are injured. If there are any signs of rectal prolapse, treatment with folk remedies is unlikely to help you. Seek immediate medical attention. If the intervention is delayed, manifestations of problems with the urinary system are possible, and the rectum is infringed.

The dangerous consequences of rectal prolapse can be:

• Intestinal obstruction;
• peritonitis.

The immune defense of the body decreases sharply, the person loses his ability to work. The nervous system is in constant tension, the patient is irritable, suffers from apathy and neuroses.

Diagnostics

When diagnosing rectal prolapse, the doctor should study the history of the disease in detail and examine the anorectal area. It should be noted that external manifestations are visible only in advanced stages. At first, the disease is not visualized. The patient is offered to strain in the position "on his haunches" or "on the stool". When the intestine appears, the diagnosis is confirmed. A finger examination can be used, for this purpose the patient is located in the viewing chair. Upon examination, the doctor evaluates the muscle tone and elasticity of the anus. If straining the volume of the rectum increases dramatically, then this indicates a disease.

Defining the degree of rectal prolapse is assigned defecography. During the procedure, the act of defecation is simulated, with radiographic shots taken, the doctor will determine the severity of functional and anatomical abnormalities, determine the methods of surgical intervention.

Anorectal manometry will help evaluate the functioning of the muscles that are located around the intestine, and also assess their role in the process of defecation.

Also used in diagnostics are such instrumental methods as colonoscopy, sigmoidoscopy. Each method when diagnosing helps to supplement the picture of the disease, to clarify the stage of the disease.

Conservative treatment

The procedure for treating rectal prolapse is based on the parameters of the examination, the diagnosis. The doctor must determine the specific medical tasks. Medical measures can be divided into two main areas: conservative and surgical.

If the diagnosis of "rectal prolapse" is established, treatment with conservative methods is justified only at the first stages of the disease. It is often prescribed to young or middle-aged patients. The main tasks of conservative treatment will be to eliminate the causes that led to the development of prolapse. This includes:

• Identification and treatment of all pathologies that are found in the large intestine.
• Normalization of the stool.
• It is necessary to eliminate constipation.
• Exception of all physical activities, lifting of any weights, loads.
• Sexual life should be safe (exclude any stimulation of the anal passage).

It is very important for the patient to choose the right physical culture, which would be performed daily and strengthened the muscles of the pelvic floor and perineum.

Also conservative treatment may include:

• Sclerosing drugs (injection course);
• Rectal massage;
• Physiotherapy (stimulation with electric current).

Conservative methods of treatment can help only in the early stages of the disease (only in 2/3 of cases). Most often, the patient needs surgery.

Surgery

The methods of surgical treatment of rectal prolapse are complicated every year and improved. To date, there are about fifty methods of intervention. The choice is determined depending on the task. The conduct of an operation depends on the following factors:

• Degree of development of the disease;
• Individual anatomical features;
• Age of the patient;
• State of health.

The main directions of the surgical operation are:

• Removing a drop-out section of the rectum.
• Removal of a specific affected area of the large intestine.
• Complex of plastic measures. There is a ligation of the rectum, the possibility of adjusting some pelvic muscles in the intestinal canals.
• Combination of several methods of surgical intervention.

Modern proctologists often practice the method of lining the rectum, while it is less injured. The patient easily tolerates the intervention, and recovery from rectal prolapse surgery takes place in a short time.

There is also an improved bloodless procedure for the treatment of prolapse - laparoscopy. The recovery period is accelerating, the risks of complications are minimized.

For most of the operations, the forecasts are very positive:

• Elimination of symptoms.
• Complete recovery.
• Improving the quality of life.
• Elimination of psychological trauma.

After surgery, the operability of the anal sphincter gradually returns to normal, the tone improves, the functions are restored. The specific results of treatment can be judged a year later.

Prevention

Measures to prevent rectal prolapse are very simple. In order not to lead to a pathological condition, it is necessary to eat right: more to eat vegetables, fruits, greens, fiber, less to include in the diet (and better to exclude) semi-finished products, smoking, salting. In general, nutrition should facilitate the easy work of the digestive tract (gastrointestinal tract) and the correct act of defecation.

In time, treat any rectal disease that can lead to prolapse. Do physical exercises, perform exercises that strengthen the muscles of the pelvic floor. Already from childhood, teach children to go to the toilet correctly, do not push hard and do not sit too long on the pot.

Beware of any physical overload, leading to an increase in intra-abdominal pressure.

As prophylaxis proctologists do not recommend doing any anal types of sex.

Disease in children

Rectal prolapse in children manifests itself most often at the age of 1-4 years. In boys, this pathology occurs more often (a ratio of two to one). Prolapse occurs due to any complications after GI diseases, with intra-abdominal pressure increasing. Factors that contribute to the prolapse of the rectum:

• Atrophy of fatty tissue, as a consequence, weak fixation of the gut.
• The laxity of the perineum is congenital.
• Hypotrophy, rickets.
• Constipation, diarrhea.
• Dysentery.
• Long stay on the pot.
• Anatomical features.
• Complication of hemorrhoids.

Also, you should pay attention to the genetic predisposition, type and diet, the transferred diseases, possible dystrophic changes.

The initial symptomatology is not easy to notice in a child. With the act of defecation, the mucous membrane can turn out of the passage and then return to its natural position. To detect the problem, parents should examine the anus of the child during the stool, whether there is a red rosette that falls out of the anus. If a problem is found, you should immediately contact the doctor.

If the treatment is not available, the progression of the disease may begin. With the development of muscle hypotension, the rectum will begin to fall out with each defecation. In these cases, it will no longer be able to self-correct, it will have to be done manually. With further development of the pathology prolapse can occur in the child with any straining, coughing, crying, laughing. Because of the weakness of the muscular sphincter, stool incontinence may occur. Infringement of the intestine can threaten not only health, but also the life of the baby, in this case only surgical intervention will help.

Treatment of rectal prolapse in children

Methods of treatment of rectal prolapse in children at early stages are based on conservative and sclerosing therapy. The objectives of conservative treatment are:

• Elimination of constipation.
• Dietotherapy with the inclusion of cellulose.
• Restoration of the digestive tract.
• Only lie on the back (on the back or on the side). Sitting is forbidden.
• Monitor the prolapse of the intestine.
• Strict hygiene behind the anal opening.
• Correctly selected medications should eliminate inflammatory processes on the intestinal mucosa.

If conservative methods do not help, resort to sclerosing therapy.

The technique is based on the introduction of a sclerosing substance into the cellulose, which will be localized in the rectum. As a consequence of the drug, patients, atrophied tissues will be replaced by cicatricial and connective structures. The rectum will be firmly fixed. The technique is rarely used, it is painfully tolerated by the child, sometimes it can cause complications.

To prevent prolapse in children should be from an early age to monitor their proper nutrition, to exclude the appearance of constipation. Teach your child to defecate quickly, do not sit for a long time on the pot.