What is the pathogenic mechanism of rectal prolapse?

Written by Chen Tian Jing

Colorectal Surgery

Updated on September 27, 2024

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The pathogenic mechanism of rectal prolapse primarily refers to the relaxation and sagging of the rectal mucosa down to the anal area, forming an internal rectal mucosa prolapse. Excessive relaxation of the rectal mucosa can protrude externally through the anus in a cylindrical or conical shape, commonly known as external rectal mucosa prolapse or rectal prolapse. The causes are mainly due to congenital deficiency of kidney energy in patients or excessive relaxation of the rectal mucosa due to multiple childbirths. Some patients with long-term constipation may also experience rectal mucosal relaxation due to excessive straining during bowel movements. Additionally, elderly and frail patients may experience sagging of the rectal mucosa as they age.

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Written by Chen Tian Jing

Colorectal Surgery

1min 2sec

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What tests should be done for rectal prolapse?

Rectal prolapse primarily refers to excessive laxity of the rectal mucosa within the anal canal. This lax mucosa accumulates at the anal opening, forming a clinical symptom. Patients may experience significant local swelling and a feeling of falling down. In severe cases or when the prolapse overly obstructs the anal opening, it might lead to difficulties in defecation and constipation. To diagnose rectal prolapse, an initial assessment typically involves a digital rectal examination and an anoscopy to simply and initially screen for the presence of mucosal prolapse. Further, a defecography might be required to ascertain the severity of the rectal prolapse. For mild rectal prolapse, topical medications can be used to alleviate symptoms. In cases of moderate or severe rectal prolapse, surgery is necessary to excise the lax mucosal loop.

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Written by Chen Tian Jing

Colorectal Surgery

59sec

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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.

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Written by Deng Heng

Colorectal Surgery

48sec

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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.

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Written by Deng Heng

Colorectal Surgery

41sec

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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.

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Written by Chen Tian Jing

Colorectal Surgery

57sec

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Can you get pregnant with rectal prolapse?

Patients with rectal prolapse can become pregnant, but if diagnosed with rectal prolapse before pregnancy, it is advisable to first surgically remove the prolapsed mucosa. This is because during pregnancy, as the fetus grows, the pressure in the abdominal cavity gradually increases. Female patients may experience worsening of the rectal prolapse due to increased abdominal pressure, which could lead to increased congestion and edema, thereby exacerbating the severity of existing hemorrhoids or the severity of the rectal prolapse. Therefore, if there are symptoms of rectal prolapse before pregnancy, surgical treatment is recommended. If rectal prolapse occurs during pregnancy, conservative treatment with traditional Chinese medicine enemas can be chosen, and surgery can be considered after childbirth.