Rectal Prolapse – Symptoms
Generally, you will first experience Rectal Prolapse during a bowel movement. You may have a prolapsed rectum in case you experience the following symptoms –
- Feeling a bulge outside the anal opening
- Finding a red mass outside the anus
- Pain in the anus or rectum
- Leaking stool or blood
- Leaking mucus from the anus
Rectal Prolapse – Causes
You can develop a prolapsed rectum due to several reasons. These may include –
- History of diarrhea
- History of straining while passing stool
- Pregnancy
- Weakened muscles and ligaments around the rectum (mostly due to old age)
- Injury in the anal or hip area in the past
- Nerve damage that affects the ability of your muscles to flex or release
Women have a greater probability of developing Rectal Prolapse than men, especially those above age 50. Even young children are at a risk of having a prolapsed rectum.
Rectal Prolapse – Diagnosis
Rectal prolapse can be of 3 different types –
- Internal prolapse – the rectum has dropped down but hasn’t protruded out of the anus.
- Mucosal prolapse –part of the rectum protrudes through the anus
- External prolapse – the entire rectum protrudes through the anus.
The first few couple of times, the rectum may return inside on its own. However with time, it may protrude outside the anus permanently.
To decide on the best treatment for you, the doctor may perform the following diagnosis –
- In case your prolapsed rectum returns inside by itself, you may have to strain and mimic a bowel movement in a rectal examination for the doctor to confirm the diagnosis.
- To examine an Internal Rectal Prolapse, your doctor may recommend imaging tests like ultrasound and X-ray.
- In case you have rectal bleeding, the doctor may order a test to check for bowel cancer.
Rectal Prolapse – Treatment
For children, doctors generally just recommend increased fluid intake, fibrous food and exercise to treat Rectal Prolapse.
You may also be asked to use stool softeners or push back the fallen tissue into the anus by hand, if your case is very early or minor.
Additional treatment procedures for Rectal Prolapse may include –
- Using surgical rubber bands to secure the structures
- Open abdominal surgery – a large cut is made in the abdomen and your rectum is secured to the central bone of your pelvis by stitches.
- Laparoscopic abdominal (keyhole) surgery – a minimally invasive surgery using a tiny camera that is inserted into your abdomen via a few small incisions.
- Anal surgery – the doctor pulls the prolapsed rectum through the anus, removes a part of it and attaches the remaining rectum to your large intestine. This treatment is usually recommended for older people.
Rectal Prolapse – Risks & Complications
A Rectal Prolapse surgery can pose serious complications. These may include:
- Haemorrhage
- Infection
- Injuries to nearby structures
- Lack of healing at the site where structures are reconnected
- Strangulation of the rectum i.e. cut off from blood supply
- Death of rectal wall
- Recurrence of Rectal Prolapse
Rectal Prolapse – Pre Op Care
- Maintain a fast before the surgery as directed by your doctor.
- You may be given an enema solution to clear the bowel.
- Shower using an antiseptic soap before surgery.
- Inform your doctor about ongoing medication and supplements.
Rectal Prolapse – Post Op Care
- Avoid strenuous activities.
- Drink plenty of fluids.
- Consume fibrous food.
- Avoid caffeinated drinks.
- Use stool softeners if recommended by your doctor.
- You may require physical therapy to relearn how to use the pelvic floor muscles.
- Inform the doctor if you have a fever.