All about Rectal Prolapse and its treatment
Rectal prolapse is a medical condition when the rectum (end part of the large intestine) moves out of its normal position and pushes through the anus. Rectal prolapse mostly happens at old age and is found in patients who have a long history of constipation. The pelvic muscles become weak and can no longer hold the rectum in its position. It is mostly found in postmenopausal women above the age of 50. It is also found in young children and infants which could be an early sign of cystic fibrosis.
A person suffering from rectal prolapse may have doubts such as:
- What happens during rectal prolapse?
The anal sphincter helps to hold the stool and controls the urge to pass the stool. The anal sphincter also has pudendal nerves that help in controlling the passing of stools. Damage of the pudendal nerves due to injuries, surgery, or other medical conditions like diabetes can cause incontinence in defecation. During a rectal prolapse, the stool along with mucus passes in an uncontrolled way and the person has no control over his bowel movement. In prolonged rectal prolapse, patients may experience rectal bleeding as well. Many women have complained of vaginal prolapse or a bulge in the vaginal wall along with rectal prolapse. This generally happens due to childbirth and may need separate treatment.
- Is rectal prolapse hemorrhoids?
Rectal prolapse should not be confused with hemorrhoids. A hemorrhoid is a condition where there is abnormal development of inflamed blood vessels near the anus. These blood vessels may cause throbbing pain, itching sensation, discomfort during the passing of the stool, and leakage of blood from the anus. However, though rectal prolapse may look like hemorrhoids, both are different medical conditions and need different treatment approaches.
- Who are at risk of developing rectal prolapse?
Generally, older people with a history of chronic constipation are at risk of developing rectal prolapse in the future. However, compared to men, women over 50 are more prone to develop the disease. People with a long-term history of constipation or diarrhea can develop the disease at a later age. It is also believed that women with multiple vaginal births can also develop the disease at old age. Other medical problems like weakness of the pelvic muscles, infections, or injury to the ligaments of the intestinal wall can also cause rectal prolapse.
Rectal prolapse is of three types:
- External prolapse: Here, the whole rectum protrudes out of the anus.
- Mucosal prolapse: The interior rectal lining sticks out of the anus.
- Internal prolapse: The rectum has started to prolapse but is still inside and has not protruded out of the anus.
Rectal prolapse can be due to many reasons such as:
- History of chronic diarrhea or constipation
- A long history of exerting pressure or straining while passing stools
- Weak pelvic and sphincter muscles
- Weakening of pelvic muscles due to old age
- Family history of rectal prolapse
- Injury in the rectum, anus, or pelvic area
- Nerve damage in the rectal area. This can be caused during vaginal childbirth, surgery on the back or in the pelvic area, injury in the spine or the spine, sphincter injury, etc.
- Parasitic infections due to pinworm or whipworm. Schistosomiasis, a parasitic infection can cause rectal prolapse
- Digestive problems or poor diet can lead to rectal prolapse
- Other diseases like diabetes, COPD (chronic obstructive pulmonary disease), cystic fibrosis, etc.
- Hysterectomy (surgical removal of the uterus)
- Spinal cord transection or tear in the spinal cord
- Congenital bowel diseases like Hirschsprung’s disease or IND (intestinal neuronal dysplasia)
- Benign prostatic hypertrophy (enlargement of the prostate gland)
In the beginning, the symptoms may look like hemorrhoids where you may feel something is sticking out of the anus while passing stools. During the first few times, the rectum will pull back on its own but after some time, you may feel as if something has moved out of your body during bowel movements. The rectum can be pushed back into the body manually. Other symptoms include:
- The appearance of a red mass outside the anus
- Rectal bleeding
- Pain in the rectum or anus
- Blood or mucus in the stool
- A bulge near the anus
- Pain in the lower abdomen
- Feeling constipated or unable to clear the bowels completely
- Difficulty or pain in bowel movement
- Liquid feces after the bowel movement
- Inability to control bowel movements
Your doctor may conduct a preliminary rectal exam. He may ask you to sit in a commode and try to pass stool or at least exert pressure so that your doctor can see and evaluate the condition. This may be embarrassing, but is an effective way for the doctor to confirm the condition. Apart from this, other tests will be performed that will help in the final diagnosis and treatment.
- EMG or anal electromyography: This test evaluates the level of damage of the anal sphincters and the working of the anal muscles and the rectum.
- Anal manometry: A thin tube is passed through the anus and the rectum to examine the strength of the anal sphincter muscle.
- Anal ultrasound: A small probe is used to take images of the anal sphincter.
- Pudendal nerve terminal motor latency test: This evaluates the working of the pudendal nerves that are responsible for bowel control.
- Proctography: This test is also known as defecography where an x-ray video is taken to see the functioning of the bowel movements. It helps to understand how well the rectum can hold or release the stool.
- Colonoscopy: A long tube with a camera is inserted into the anus that moves up through the rectum to the joining of the large and small intestine. It takes pictures to see what is the cause of the problem.
- Proctosigmoidoscopy: This test is similar to colonoscopy where a flexible tube fitted with a camera is used to view the lower colon and to look for any inflammation, tumor, or scar tissue.
- MRI or Magnetic Resonance Imaging: An MRI is done to examine the pelvic organs.
In early prolapse especially in minors, doctors may suggest home remedies such as a diet change or stool softeners and to push back the exposed tissues back into the anus. However, in most cases, surgery is the only probable option for the treatment of rectal prolapses.
Surgical approaches depend on several factors such as the age of the patient, the severity of the prolapse, and other underlying health problems.
There are two types of surgical approaches:
- Abdominal procedures: In this procedure, laparoscopy is done or an incision is made in the abdominal muscles to do the operation. Doctors usually use general anesthesia during the operation. There are two types of approaches:
- Rectopexy: This procedure can be done where a suture is made with the help of robotic assistance or through laparoscopy where small incisions are made. This is done to reattach or fix the rectum.
- Resection: Depending on the severity of the disease, doctors may perform a resection after the rectopexy is done where a portion of the damaged rectum may be removed. This is mainly done when there is severe constipation.
- Rectal procedures: This is usually done on aged patients with other medical conditions. These procedures are done under spinal or epidural anesthesia. Rectal procedures include:
- Altemeier procedure: Also known as perineal proctosigmoidectomy where the part of the rectum that is protruding out of the anus is amputated or cut off and the remaining portion of the rectum is stitched back into its original position.
- Delorme procedure: The part of the inner lining of the rectum that has been exposed out is removed and the outer lining is stitched back inside the anus with the remaining inner lining of the rectum.
Like any other surgeries, rectal prolapse surgeries are also susceptible to certain risks such as:
- Rectal bleeding
- Intra-abdominal bleeding
- Slow healing especially when a portion of the rectum has been amputated
- Urinary retention or difficulty passing the urine
- Fecal incontinence or difficulty in controlling the bowel movements
- Other medical conditions such as deep venous thrombosis, panic attacks, heart attacks, or pneumonia
- Recurrence of the disease
If rectal prolapse is not treated in time there may be other complications like:
- Damage to the rectum
- Bleeding or ulceration of the rectum
- You can no longer push back the rectum manually
- Strangulation can reduce the supply of blood into your rectum
- Gangrene of rectal tissue
Rectal prolapse in medical terms means a large portion of your rectum, which is the last portion of the large intestine, has slid out of the anus. Although this may not be a medical emergency, patients experience emotional problems as it adversely affects their quality of life.
Why Laparoscopic rectal prolapse surgery is better than open surgery?
Laparoscopy has proved to be an effective tool to treat rectal prolapse. Laparoscopic specialists in Bangalore have years of experience and skill in leading successful surgery and offer a complete cure for this condition.
Benefits of Laparoscopic Rectal Prolapse Surgery in Bangalore
- Higher success rate
- Lower risk of blood loss
- Reduced pain
- Reduced duration of hospital stay
- Faster recovery
Approach quick and complete healthcare from goficure
As a patient already grappling with the challenges of rectal prolapse, finding the best form of healthcare solution in Bangalore can be like navigating through a maze. Goficure is already working with leading laparoscopic specialists. Facilitating complete care in Bangalore for your rectal prolapse is quick and easy with us.
What you get from Goficure services :
- Customized care from diagnosis to recovery
- Getting you the fastest appointment with expert doctors in Bangalore
- Scheduling the surgery
- Facilitating pick up and drop before and after the procedure
- Complete management of insurance claims
- Tracking post-op care with an emphasis on nutrition and diet
Goficure has everything you need for complete care for rectal prolapse under one umbrella. It will save you time, effort, and money while enabling the best cure for your condition.
Exclusive features you get with goficure
1. Dedicated Medi-Pal
A dedicated Medi-Pal is assigned to you. Your Medi-Pal will be your one point contact throughout the treatment and post-op period. They will always be available for you
2. Quick doctor’s appointments
After understanding your concerns, your Medi-Pal will schedule your consultation with a specialist doctor. Your doctor will carry out necessary tests and advise the course of treatment
3. Hassle-free treatment
If you opt to get the surgery done, goficure will take care of it completely. Right from booking your surgery, claiming your insurance to being with you throughout the procedure, your Medi-Pal will do it all
4. Post-op recovery support
Your Medi-Pal would ensure quick recovery. This includes booking your follow up consultations and helping you with doctor-recommended steps for diet & exercise
Smooth and hassle-free
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Our engagement doesn't end after your surgery. It continue until you go back to your normal life. Free diet and exercise consultations during your recovery phase are offered to ensure a quick recovery