What if the baby has a prolapse of the rectum? Causes

In medical practice, frequent clinical cases are diseases of the intestine. At the child prolapse of a rectum also it is possible to name a widespread problem. Pathology is the displacement of the walls of the distal part with their subsequent fall through the anus.

Why does the intestine appear in children?

As a rule, the disease is diagnosed in early childhood. At the same time, boys under the age of 5 are much more likely to be affected.

Before considering in detail the prolapse of the rectum in the child and its pathogenesis, it is worthwhile to pay attention to the fact that an independent disease this problem can not be considered. Most often it appears as a consequence of various pathological conditions. In an adult, as well as in a child, the prolapse of the rectum is mainly caused by an increase in intra-abdominal pressure. In turn, factors favorable to this process are considered to be the root causes of the origin and formation of the disease. They are divided into two groups.

Predisposition to the origin of pathology

The first include predisposing factors that provoke the disease. It:

1. Congenital addiction. It is caused by the fact that in children under 6 years of age in the area of the bones of the lumbosacral section, the natural concavity is rather weakly expressed. Due to the lack of lordosis and insufficient pelvic incline, the rectum is straight. With increased intra-abdominal pressure, the entire load is transferred to the anus.
2. Depth of Douglas space. The more this value (which is characteristic of young children), the lower are the vestibular cavities in the peritoneum. At a high pressure on the front wall invagination occurs, which is a good reason for the development of pathology in the child. Rectal prolapse can occur in the presence of other anatomical features in childhood: a long mesentery, a loose type intestinal arteries, etc.
3. Other gastrointestinal diseases caused by malnutrition or inappropriate feeding. In this case, the pathology develops as a result of dystrophic abnormal changes in the muscles of the pelvic floor and near-rectal tissue.

Acquired factors causing bowel prolapse

The second group of causative factors includes acquired disturbances in the functioning of the digestive system and the digestive system, which served as a starting point for the appearance of the problem. At the child a prolapse of a rectum (what to do or make to parents in this case, the expert will prompt, therefore independently to undertake measures on treatment of the kid it is strongly recommended) often arises because of disturbances of a chair. Difficulties during the act of defecation in the form of regular constipation is the main mechanism for triggering the development of the disease. Frequent straining and prolonged stay on the pot adversely affect the condition of the anal sphincter.

Meanwhile, quite often, other factors can cause increased pressure in the abdominal cavity, which provokes prolapse of the rectum in children. The causes of this pathological phenomenon are often found in a nasal cough with bronchitis or difficulty urinating (for example, with phimosis in boys).

In addition, for the manifestation of this serious pathology, as a rule, the determining factor is played by a combination of factors. In most cases, in the presence of one or more of the above problems, the prolapse of the rectum in the child occurs gradually.

Features of the symptoms of the disease in children

The danger of this pathology is that its first symptoms for a long time can remain completely invisible. The reason for this is the prolapse of the rectal mucosa. In children, this happens most often unilaterally and in stages. During acts of defecation, the portion of the intestine partially falls out, and after the process is completed, it disappears behind the sphincter.

During this period, the baby's parents can notice reddening in the area of the anus, resembling a rosette. In fact, this manifestation must be alarmed by parents. Bloody staining of the anus also serves as a clear sign of bowel prolapse. Progressive disease is characterized by more severe symptoms. Characteristic can be called a slit or stellate hole in the middle of a slightly cyanotic shade.

Signs of a progressive disease

In addition, for a long time the tone of the anal sphincter is preserved, it is hard to fix the fallen area of the gut, so any attempts are accompanied by painful sensations in the child. The prolapse of the rectum in the future manifests itself in the hypotonia of the pelvic floor musculature, as a result of which it is possible to put the fallen part back into the anal canal without difficulty, but it immediately falls out.

When the pathology is triggered, the drop-out part often acquires significant dimensions, sometimes making up the length of the entire organ. Each prolapse of the rectum in children (the photo can not be imagined from ethical considerations) is uncontrolled, for example, when sneezing or coughing, with little physical exertion. Most often, this element is only modifiable manually. The weakness of the external sphincter contributes to aggravation of the pathological state of the child, where a huge problem is the incontinence of faeces.

At the same time, the preservation of the contractile capacity of the sphincter muscles can have a negative impact on the development of the disease and lead to such a complication as mucosal entrapment. In this case, the child will need an emergency surgical procedure.

How is the treatment of bowel prolapse?

Parents, when they turn to specialists with this problem in a timely manner from their baby, may not worry. Most often, the prognosis for recovery is very favorable. In addition, the tactics of therapy are more conservative in comparison with the treatment of adult patients. With the help of folk remedies, it is impossible to overcome the prolapse of the rectum in children. Treatment should be conducted only under the supervision of specialists who coordinate the use of certain drugs and procedures.

In individual order, depending on the clinical picture of the manifestation of the disease, the baby's well-being and the duration of the course of the pathology, the doctor prescribes one of three variants of differentiated therapy:

• Treatment of a conservative plan;
• Sclerosing method;
• Operative intervention.

Conservative treatment

The first variant of therapy for prolapse of the rectum in a child under 5 years is the most common and in demand. With the loss of mucosa this type of treatment is shown in most cases to older children. The main tasks of this complex of rehabilitation measures are:

• Stabilization of character and elimination of any disorders of stool, defecation;
• Early establishment of a normal mode of intestinal emptying;
• Selection of the most appropriate diet during the adjustment of nutrition.

All this can be achieved only with the help of diet therapy. Eliminate the root cause of the disease - high intra-abdominal pressure - you can by choosing the best suitable nutrition plan with the necessary appropriate relief or fixation effect. In the absence of positive dynamics, the doctor may prescribe the use of special medications.

Therapy without a pot

As soon as the correct mode of defecation is established, it is extremely important to save the child from frequent desires for emptying. To restore the pelvic muscles and their functional connections, the violation of which causes the prolapse of the rectum in children, Komarovsky recommends minimizing the possible stress and straining. As a rule, during the treatment the child is not allowed to use the pot or toilet bowl, it should defecate exclusively in a recumbent or standing position. Absence of a load on the anus is one of the basic conditions for the therapy of this pathology, and this moment requires a lot of patience and attention on the part of the parents.

Often for complete recovery, a similar regimen is prescribed by a doctor for a period of about 3-4 months. The success of such treatment guarantees almost a 100% result. Advantages of this method of treatment are obvious: there is no outside interference in the children's body, self-healing occurs due to the restoration of muscles and the shortening of their fibers.

However, recovery does not mean that the result is achieved finally and the child does not face a relapse. Over the next year it is extremely important to monitor his condition and, in case of repeated dropping, put the gut into the anal canal as quickly as possible.

How can I put the baby's bowel to my child?

Particular attention deserves familiarization with the nuances of the technique of correction. Regardless of age, the prolapse of the rectum in a child (2 years or 6 years) requires urgent, uncomplicated manipulation. The main thing that the baby was calm, as relaxed as possible. The child should lie on his back. The missing fragment of the rectum should be lubricated with a lubricant, after which, after putting on the gloves, grasping it with the fingers of both hands and without forceful efforts, gently and gently inward. It should start from the central part, because with the correct technique, the edges of the fallen intestine spontaneously slide into the anal canal. As soon as the inserted fragment is inside, it is important for the child to slowly turn over to the stomach and reduce the buttocks.

How does sclerotherapy work?

In more complex, neglected cases, treatment is performed in a hospital setting and, as a rule, resorted to the help of a surgeon. Sclerosing therapy, which is often used today, is also a method of surgical intervention. The procedure is the introduction of special substances, the action of which is aimed at swelling of the peritopulmonary tissue. Further, the expected necrosis of cells occurs, which is replaced by sclerosis and scarring of tissues surrounding the rectum. This allows you to tightly fix their epithelium and the surface of the bowel.

Possible complications of sclerosing

Meanwhile, most specialists in the field of pediatric surgery are very reserved about this method of treatment. The reason for this is the frequent introduction of drugs, as well as a high risk of developing necrotic complications of the internal walls of the intestine. Sclerosing therapy can take place only when the conservative treatment option has been completely unsuccessful or there is a considerable likelihood of developing an infringement.

The second method of surgical intervention involves rektopeksiyu - removal of the drop-out area according to the Zerenin-Kummel method.

In any case, every disease, including the prolapse of the intestine in children, is much easier to prevent than cure. To prevent development, pathology, any potentially dangerous factors should be prevented. In particular, do not make the baby sit for a long time on the pot and take urgent measures with the slightest violation of the stool.