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Rectal prolapse
What causes rectal prolapse?
There are many causes of rectal prolapse. If there are no external factors involved, the most common cause is generally due to poor physical constitution and insufficient central qi, leading to a relaxed and sagging state of the intestinal mucosa. In some children, due to insufficient congenital development and weak kidney qi, there may be temporary prolapse. As the child's pelvic structure and tissues develop, symptoms of prolapse will ease. Another group of cases occur in women who have given birth multiple times. Due to excessive strain in the anal area and pelvis during natural childbirth, or increased negative pressure during pregnancy compressing the local mucosa and tissues of the anus, rectal prolapse may occur after childbirth. Mild symptoms of rectal prolapse can be alleviated with conservative medication, while severe symptoms or those affecting the patient's life may require surgical treatment.
Rectal prolapse and internal hemorrhoids differences
Although both rectal prolapse and prolapse of internal hemorrhoids involve swollen or foreign objects protruding from inside to outside the anus, the protruding object in the case of internal hemorrhoids is a congested, swollen hemorrhoid, generally petal-shaped. In contrast, the prolapsed rectal mucosa has distinctive radial or circular hooks. Secondly, the tightness of the anus in cases of internal hemorrhoid prolapse is generally normal, whereas in rectal prolapse, the tightness of the anus is usually loose.
Why won't rectal prolapse heal?
The causes of rectal prolapse are complex, and they are not fully understood at present. It is considered to be related to multiple factors: The first factor is anatomical, where underdeveloped or malnourished children, or weak elderly individuals are prone to having weak and powerless levator ani muscles and thin pelvic fascia. Other anatomical issues include a less curved or overly straight sacrum in children, surgical trauma, or damage to the muscles and nerves around the anus. The second factor is increased abdominal pressure, such as from constipation, diarrhea, prostate enlargement, chronic cough, or difficulty urinating, all of which can heighten abdominal pressure and exacerbate rectal prolapse. The third factor is diseases around the anus, such as internal hemorrhoids and rectal polyps that frequently protrude, pulling down the rectal mucosa and easily inducing rectal prolapse. Therefore, its causes are complex, and so is its recovery.
Postoperative Care for Rectal Prolapse Surgery
Post-Rectal Prolapse Surgery Precautions: 1. Rest in bed, which helps improve the recovery rate. Due to gravity, many patients with rectal prolapse experience prolapse when standing or walking. Although the surgery fixes the prolapsed mucosa, the firmness of the fixation takes time to establish. Therefore, it is recommended to rest in bed with limited activity for one week after the surgery to solidify the therapeutic effects. 2. Take oral antibiotics for 7 to 10 days after surgery. 3. Abstain from food for the first two days after surgery, and consume semi-liquid or liquid foods in reduced quantities on the third day. 4. Refrain from defecating for 4 to 5 days after surgery. 5. Do not strain during the first bowel movement after surgery. (Please use medications under the guidance of a professional physician)
Clinical manifestations of rectal prolapse
The main symptom of rectal prolapse is a swelling that protrudes from the anus. In the early stages, the swelling is small and only protrudes during defecation, retracting on its own afterwards. As the condition progresses, the protrusion occurs more frequently and grows larger, requiring manual assistance to push it back into the anus after defecation. This is accompanied by a feeling of incomplete bowel evacuation and a feeling of heaviness. If not addressed promptly, the prolapsed intestine may become swollen, constricted, incarcerated, and even risk necrosis. As the prolapse worsens, it can cause varying degrees of anal incontinence, accompanied by the discharge of mucus, which leads to eczema and itching around the anal area.
Rectal prolapse symptoms
The symptoms of rectal prolapse mainly refer to local mucosal relaxation in the anal canal, which leads to the prolapse of the internal mucosa outside the anus, or excessive relaxation of the mucosa that accumulates at the anus, forming an internal mucosal prolapse of the rectum. Rectal prolapse may also manifest as local bloating, pain, and a feeling of falling in the patient. Due to repeated prolapses, it may also cause difficulties in defecation due to mucosal accumulation at the anus, or form outlet obstructive constipation. Therefore, whether it is internal mucosal prolapse of the rectum or prolapse that leads to rectal prolapse, it is advisable for patients to undergo surgical treatment as soon as possible to avoid aggravating the condition and delaying treatment.
Is rectal prolapse the same as hemorrhoids?
Rectal prolapse and hemorrhoids are two different diseases. Rectal prolapse refers to the condition where the rectal mucosa, or sometimes the entire rectal wall, prolapses downwards during defecation, prolonged standing, or fatigue, especially in severe cases. Hemorrhoids, on the other hand, involve the prolapse of vascular cushions and anal padding, sometimes accompanied by symptoms like rectal bleeding. The causes, mechanisms, pathology, symptoms, and treatment methods of these two conditions are distinct, making rectal prolapse and hemorrhoids two separate diseases.
Can rectal prolapse cause stool deformity?
Rectal prolapse primarily refers to the excessive relaxation of the rectal mucosa. It may manifest as relaxation of the rectal mucosa due to the prolapse, and may also result in rectal prolapse. Patients with rectal prolapse may experience deformed stools, mainly because the prolapse overly crowds the anal opening, preventing feces from being normally expelled from the body. When feces are expelled through the anus, the local mucosal compression can cause the stools to appear in thin strips or in a flattened shape. Patients with rectal mucosal prolapse are advised to undergo examinations as soon as possible and actively receive treatment. Options include traditional Chinese medicine retention enemas, combined with oral qi-boosting medications. If the prolapse recurs, or has resulted in rectal prolapse, surgical treatment is recommended.
The difference between rectal prolapse and rectal prolapse
The term "rectal prolapse" used in folk vernacular covers a wide range, such as incarcerated hemorrhoids, inflammatory external hemorrhoids, thrombosed external hemorrhoids, rectal polyps, and rectal prolapse itself are all referred to as rectal prolapse. Of course, this also includes cases where, due to a lack of medical knowledge, any tumors or flesh-like growth protruding from inside to outside the anus are collectively termed as rectal prolapse. It is evident that the folk term “rectal prolapse” includes conditions like prolapsed rectum, prolapsed internal hemorrhoids, or prolapsed polyps, while the modern medical definition of rectal prolapse specifically refers to the protrusion of the rectum and its mucous membrane; the two should not be confused.
How to treat rectal prolapse?
Rectal prolapse mainly includes external rectal mucosal prolapse and internal rectal mucosal prolapse. External rectal mucosal prolapse primarily refers to the symptoms and types of clinical rectal prolapse. The most common and effective treatment for rectal prolapse or internal rectal mucosal prolapse is surgery. Simple medication can only relieve local relaxation or compressive symptoms, but it does not have a definitive therapeutic effect on the disease itself. The surgery mainly involves the removal and excision of the relaxed and prolapsed mucosa, thereby increasing the tightness of the intestinal mucosa and relieving the local mucosal pressure on the anus, which causes the patient's feelings of bloating and descent. After the surgery, patients need to rest in bed for a week and should avoid squatting and excessive abdominal straining in their future activities.