A small number of patients suffer from prolapse of the rectum; the problem is not common. However, in recent years there has been a tendency to increase the disease. Rectal prolapse (the so-called this disease) is not life-threatening in itself, except in cases of collapse, but nevertheless it causes 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 located slightly above the anus, stretches, becomes mobile and falls out with pressure. Prolapse is most often caused by a weak anal sphincter, which may result in incontinence of mucus and feces. Pictures and photos of rectal prolapse indicate the external manifestations of the disease - the rectum, with its lower part, extends beyond the canal.
The disease always causes physical pain during bowel movements, psychological discomfort, characterized by sphincter incontinence (blood, mucous discharge). Rectal prolapse is dangerous for both children and adults.
With pathological changes, stretching of the lower rectum (its terminal zone) occurs, we are talking about the visible area, which reaches up to 20 cm in length.
The disease is debilitating, difficult, although not life threatening. Symptoms reduce 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. It can be diagnosed at any age, even in babies. It is noted that in men this problem is detected more often. Doctors urge to take the necessary serious preventive measures.
Rectal prolapse: causes
The causes 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 tears formed and pelvic muscles were injured;
- bowel surgery;
- hard physical work, when the muscular apparatus is constantly tense, intra-abdominal pressure rises;
- the sacral section is in some way injured;
- ulcers form on the intestinal mucosa.
There are other causes of rectal prolapse. Photos and pictures confirm the existence of human anatomical features. In these cases, predisposing causes arise:
- pathology of the pelvic muscles;
- sphincter has low muscle tone;
- increased abdominal pressure;
- deepening in the rectum;
- bowel muscle strain;
- lengthening of the intestine, spray;
- coccyx is located vertically;
- difficult pregnancy, difficult childbirth.
Doctors pay special attention to pathologies that arise in connection with non-traditional sexual preferences. A provoking factor in the occurrence of rectal prolapse can be constant painful stimulation of the anus. As a result, not only pain occurs, but also prolapse of the rectum.
Types and stages
According to its typology, this disease has the following options:
- The prolapse is determined by the downward displacement of the front wall - this is a hernial option. It occurs with weak muscles of the pelvis, with an increase in intra-abdominal pressure. The rectal mucosa is squeezed and excreted.
- Inside the mucosa of the anus, there is an indentation of part of the sigmoid or rectum, there is no way out - this is an invagination option.
According to the basics of the mechanisms of the development of the disease, proctologists distinguish stages of the disease (degree) from rectal prolapse:
- Compensated minor stage. In the process of defecation, a slight inversion of the intestine occurs. At the end of the stool process, the intestine independently returns to its original position.
- Subcompensated, deeper stage. The intestine falls out, as in the first case, however, it returns slowly to its original position, and pain and bleeding occur.
- Decompensated, intense stage. Rectal prolapse is not only in the process of defecation, but also with any intra-abdominal pressure, tension, while the intestine does not set itself. Often there are bleeding, possibly incontinence of feces, gases. The sphincter is in a relaxed state for a long time.
- Decompensated deep, permanent stage. With any physical exertion, in any position (sitting, standing), prolapse of the intestine occurs. Necrotic processes developing on the mucosa cause bleeding, itching, pain.
Symptoms and signs of the disease, complications
The development of the disease can occur at a slow pace, but can occur suddenly. Most often, prolapse develops gradually. At first, bowel prolapse can only occur with bowel movements. With the progression of the disease, you have to adjust the place that falls out under any stress.
A sudden loss can provoke a sharp jump in intra-abdominal pressure with strong physical exertion. With a sharp loss, severe pain occurs, which can cause a state of shock and even collapse.
Symptoms of rectal prolapse:
- in the anus there is a sensation of a foreign body;
- frequent false desires for a bowel movement;
- persistent pain in the anus;
- the possibility of containing feces and gases disappears.
With prolapse of the intestine , bleeding occurs, vessels are injured. If there are at least some signs of rectal prolapse, treatment with folk remedies is unlikely to help you. Seek qualified medical attention immediately. With delayed intervention, manifestations of problems with the urinary system are possible, the rectum is infringed.
Dangerous consequences of rectal prolapse can be:
- intestinal obstruction;
- peritonitis.
The immune defense of the body decreases sharply, a person loses his ability to work. The nervous system is in constant tension, the patient is irritable, suffers from apathy and neurosis.
Diagnostics
When diagnosing rectal prolapse, the doctor should study the medical history in detail and examine the anorectal region. It should be noted that external manifestations are visible only in advanced stages. At first, the disease is not visualized. The patient is invited to strain in the “squatting” or “on the stool” position. When the gut appears, the diagnosis is confirmed. A digital examination can be used, for this the patient is located in an examination chair. On examination, the doctor evaluates the muscle tone and elasticity of the anus. If during straining, the volume of the rectum increases sharply, then this indicates a disease.
To determine the degree of rectal prolapse, defecography is prescribed. During the procedure, an act of defecation is simulated, while x-rays are taken, the doctor will determine the severity of functional and anatomical disorders, determine the methods of surgical intervention.
Anorectal manometry will help evaluate the functioning of the muscles that are located around the intestine, as well as assess their role in the process of defecation.
Instrumental methods such as colonoscopy and sigmoidoscopy are also used in the diagnosis. Each method during diagnosis helps to supplement the picture of the disease, to clarify the stage of development of the disease.
Conservative treatment
The method of treatment of rectal prolapse is based on the indicators of examination, diagnosis. The doctor must determine specific medical tasks. Therapeutic measures can be divided into two main areas: conservative and surgical.
If a diagnosis of rectal prolapse is established, conservative treatment is justified only in the first stages of the disease. More often prescribed to young or middle-aged patients. The main objectives 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 colon.
- Normalization of the stool.
- Be sure to eliminate constipation.
- Exclusion of all physical exertion, lifting 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 education that would be performed daily and strengthen the muscles of the pelvic floor and perineum.
Also, conservative treatment may include:
- sclerosing drugs (injection course);
- rectal massage;
- physiotherapy (stimulation by electric current).
Conservative treatment methods can help only in the early stages of the disease (only in 2/3 of cases). Most often, the patient requires surgical intervention.
Surgery
Methods of surgical treatment of rectal prolapse are annually complicated and improved. Today, there are about fifty methods of intervention. The choice is determined depending on the task. The conduct of a particular operation depends on the following factors:
- the degree of development of the disease;
- individual anatomical features;
- patient age;
- well-being.
The main areas of surgery are:
- Removal of the rectal prolapse.
- Removal of a specific affected area of the colon.
- A set of plastic measures. Rectification of the rectum is carried out , the ability to adjust some pelvic muscles in the intestinal canals.
- Combination of several methods of surgical intervention.
Modern proctologists often practice the method of suturing the rectum, while it is less injured. The patient easily tolerates the intervention, and recovery after surgery of rectal prolapse takes place in a short time.
There is also an improved bloodless prolapse treatment technique - laparoscopy. The recovery period is accelerating, the risks of complications are minimized.
For most of the operated forecasts are very positive:
- Elimination of symptoms.
- Full recovery.
- Improving the quality of life.
- Elimination of psychological trauma.
After surgery, the performance of the anal sphincter gradually returns to normal, the tone improves, functions are restored. The specific results of treatment can be judged after a year.
Prevention
Rectal prolapse prophylaxis is very simple. In order not to lead to a pathological condition, you need to eat right: eat more vegetables, fruits, herbs, fiber, less include in the diet (and better exclude) semi-finished products, smoked, salted. In general, nutrition should contribute to the easy functioning of the gastrointestinal tract (gastrointestinal tract) and the correct act of defecation.
Treat any rectal diseases that can lead to prolapse in a timely manner. Engage in physical therapy, perform exercises that strengthen the muscles of the pelvic floor. Already from childhood, teach children to go to the toilet correctly, not to push hard and not to sit too long on the pot.
Beware of any physical overload resulting in increased abdominal pressure.
As a prevention, proctologists do not recommend engaging in any kind of anal sex.
Disease in children
Rectal prolapse in children occurs most often at the age of 1-4 years. In boys, this pathology occurs more often (two to one ratio). Prolapse occurs due to any complications after gastrointestinal diseases, while intra-abdominal pressure increases. Factors that contribute to rectal prolapse:
- Atrophy of adipose tissue, as a result, weak fixation of the intestine.
- Perineal sagging congenital.
- Hypotrophy, rickets.
- Constipation, diarrhea.
- Dysentery.
- Long stay on the pot.
- Anatomical features.
- Complicated hemorrhoids.
You should also pay attention to the genetic predisposition, type and diet, past illnesses, possible dystrophic changes.
It is not easy to notice the initial symptoms in a child. With the act of defecation, the mucosa can turn out of the passage and immediately return to its natural position. To detect the problem, parents should inspect the anus of the child during the stool, if there is a red outlet that falls out of the anus. If you find a problem, you should immediately contact your doctor.
If treatment is not available, disease progression may begin. With the development of muscle hypotension, the rectum begins to fall out with each bowel movement. In these cases, she will no longer be able to adjust herself; she will have to do it manually. With further development of pathology, prolapse can occur in a child with any straining, coughing, crying, laughing. Due to the weakness of the muscle sphincter, fecal incontinence may occur. Injury to the intestine can threaten not only the health, but also the life of the baby, in this case only surgical intervention will help.
Treatment of rectal prolapse in children
The methods of treating rectal prolapse in children in the early stages are based on conservative and sclerotherapy. The objectives of conservative treatment are:
- Eliminate constipation.
- Diet therapy with fiber.
- Recovery of the digestive tract.
- Defecate only while lying down (on the back or on the side). Sitting is prohibited.
- Control bowel prolapse.
- Strict hygiene behind the anus.
- Properly selected medications should eliminate inflammation in the intestinal mucosa.
If conservative methods do not help, resort to sclerotherapy.
The technique is based on the introduction of a sclerosing substance into the fiber, which will be localized in the rectum. As a result of the effect of the drug, diseased, atrophied tissues will be replaced by scar and connective formations. The rectum will be firmly fixed. The technique is rarely used, it is painfully tolerated by a child, sometimes it can cause complications.
For the prevention of prolapse in children, from an early age, they should monitor their proper nutrition, to eliminate the occurrence of constipation. To teach the child to quickly defecate, not to sit for a long time on the pot.