Rectal Prolapse
The rectum is located just above the anal canal. Normally, the rectum is securely attached to the pelvis with the help of ligaments and muscles. This attachment firmly holds the rectum in place. Various factors, stress of childbirth, may cause these ligaments and muscles to weaken, which means that the rectum's attachment to the body also weakens. This causes the rectum to prolapse, meaning it slips or falls out of place. rectal prolapse are similar to those of hemorrhoids , the latter form near the anal opening, while the former involves a portion of the colon. Occasionally, large hemorrhoids may predispose the rectum to prolapse. Rectal prolapse is similar to, but not the same as, rectocele , which is a common condition in women. A rectocele is a prolapsed rectum that can result when the backside wall of the vagina prolapses. In the early stages of rectal prolapse, the rectum becomes poorly attached but stays within the body most of the time.
This stage of rectal prolapse is called mucosal prolapse, or partial prolapse, meaning that only the inner lining of the rectum protrudes from the anus. This occurs when the connective tissues within the rectal mucosa loosen and stretch, allowing the tissue to protrude through the anus. In children, rectal prolapse is probably related to certain anatomical features such as the vertical orientation of the rectum, mobility of the sigmoid colon, relative weakness of the pelvic floor muscle, mucosa poorly fixed to submucosa, and redundant rectal mucosa. Rectal prolapse can occur due to a lifelong habit of straining during bowel movement, hereditary factors, stresses due to childbirth or as part of the aging process when pelvic and anal sphincter muscles weaken.
Causes of Rectal Prolapse
Common causes of Rectal Prolapse
- Long-term straining during defecation
- Pregnancy and the stresses of childbirth
- Paraplegia.
- Previous surgery.
- Whooping cough.
- Chronic obstructive pulmonary disease.
- Constipation.
- Diarrhea.
- Pelvic floor dysfunction.
- Anatomic features.
- Neurologic disorders.
Symptoms of Rectal Prolapse
Common symptoms of Rectal Prolapse
- Mucus or blood discharge.
- Loss of urge to defecate.
- Fecal incontinence.
- Ccoughs.
- Pain.
- Anus.
- Bleeding.
Treatment of Rectal Prolapse
Common Treatment of Rectal Prolapse
- Supportive care should be provided according to clinical picture, particularly in the presence of an irreducible prolapse and with gangrene or rupture of the rectal mucosa.
- Surgical treatment can be divided into 2 categories according to the approach used to repair the rectal prolapse: abdominal procedures and perineal procedures. The choice of abdominal versus perineal procedure is mainly dictated by the patient's age and comorbidities. In general, the abdominal procedures have a lower recurrence rate but a higher morbidity rate.
- Anorectal manometry, which measures rectal muscle tone, may also be a helpful diagnostic tool.
- Several maneuvers to help reduce the prolapse have been described and include sedation, field block with local anesthetic, and sprinkling the prolapse with either salt or sugar to decrease the edema and to reduce the prolapse
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