What tests should be done for rectal prolapse?

Written by Chen Tian Jing
Colorectal Surgery
Updated on September 01, 2024
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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 Deng Heng
Colorectal Surgery
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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
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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.

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Written by Chen Tian Jing
Colorectal Surgery
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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.

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Written by Chen Tian Jing
Colorectal Surgery
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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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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)