Can rectal prolapse cause rectal bleeding?

Written by Chen Tian Jing
Colorectal Surgery
Updated on September 10, 2024
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If it is a recurrent case of rectal prolapse, as the prolapsed mucosa appears at the anus and rubs against it repeatedly when the patient walks or moves, it can lead to mucosal rupture and bleeding. Therefore, in severe cases of rectal prolapse or when a complete prolapse occurs, there might be bleeding during defecation. The diagnosis of rectal prolapse requires an examination with an anoscope and defecography to make a definitive diagnosis. For mild rectal prolapse, one can treat it with oral medications that supplement and boost the body's vital energy, and this can be supplemented with herbal enemas. For severe cases of internal mucosal rectal prolapse or complete mucosal prolapse, it is advisable to undergo surgical removal of the excess mucosa through excision or suturing. This surgery can alleviate symptoms of discomfort and prevent other complications.

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Written by Chen Tian Jing
Colorectal Surgery
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How to check for rectal prolapse?

Rectal prolapse is generally divided into internal rectal mucosal prolapse and external prolapse, also known as rectal procidentia. If it is an internal prolapse, an anoscopy combined with defecography is required to examine the degree of laxity of the local rectal mucosa. If it is an external prolapse or rectal procidentia, the patient generally presents with a prolapsed swelling when squatting, and this can be further evaluated with a digital rectal examination to assess the local tightness of the anus. If rectal prolapse occurs, surgical treatment is recommended as it tends to be quite effective. In cases of pediatric prolapse or mild prolapse, traditional Chinese medicine enemas may be used to alleviate local symptoms.

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Written by Chen Tian Jing
Colorectal Surgery
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Which department to consult for rectal prolapse?

Rectal prolapse is generally divided into internal mucosal prolapse and external prolapse. External mucosal prolapse is commonly known as rectal prolapse, which falls under the category of proctological diseases. Therefore, patients who suspect they have rectal prolapse should promptly visit a proctology department for relevant examinations and treatment. The examination and diagnosis of rectal prolapse mainly involve digital rectal examination, anoscopy, and defecography to confirm the diagnosis. Especially for internal mucosal prolapse, which cannot be seen with the naked eye, defecography is necessary for differentiation. In cases of rectal prolapse, one can generally see a ring-like protrusion outside the anus, and in severe cases, there may be conical or cylindrical prolapse. Regardless of whether it is internal mucosal prolapse or rectal prolapse, surgical treatment is necessary.

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Written by Chen Tian Jing
Colorectal Surgery
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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.

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Written by Chen Tian Jing
Colorectal Surgery
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How is rectal prolapse graded?

Rectal prolapse is generally graded into three degrees: first degree rectal prolapse, second degree rectal prolapse, and third degree rectal prolapse. First degree rectal prolapse is a relatively minor condition where the rectal mucosa protrudes but can retract back on its own. Second degree rectal prolapse is a moderate condition where the protruding mucosa extends approximately 5-10 centimeters, generally forming a conical shape, and requires the patient to manually reposition it. Third degree rectal prolapse indicates a severe condition, with the prolapsed mucosa typically extending beyond 10 centimeters. It may protrude with each incident and could also occur when the patient strains the abdomen or squats. The treatment of second and third degree rectal prolapse generally requires surgical intervention.

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Written by Deng Heng
Colorectal Surgery
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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.