The difference between rectal prolapse and rectal prolapse.

Written by Xu Jun Hui
General Surgery
Updated on November 06, 2024
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Rectal prolapse, also known as rectal prolapse, is characterized by partial prolapse of the rectal mucosa in the early stages and full-length prolapse of the rectum in the later stages. Early rectal prolapse is generally accompanied by a feeling of incomplete bowel movements, urgency followed by a feeling of incomplete relief, and perianal contact, with secretions leading to perianal eczema, itching, and infection in the later stages. If the prolapse cannot be reduced, entrapment can occur, causing pain. The initial treatment for rectal prolapse is to ensure smooth bowel movements and reduce factors that increase abdominal pressure to avoid causing the rectal mucosa to protrude outward. Severe rectal prolapse may require surgical treatment.

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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 Chen Tian Jing
Colorectal Surgery
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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
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Can you have children with rectal prolapse?

If a patient is diagnosed with rectal prolapse, they can still have children. However, childbirth can potentially worsen rectal prolapse, especially during natural delivery, where excessive straining in the pelvic and anal areas can exacerbate the condition. Therefore, if a patient already has rectal prolapse, it is advised to consider surgical removal treatment before pregnancy. If rectal prolapse occurs during pregnancy, external wash medications and hot compresses can be used to promote retraction. If rectal prolapse occurs during delivery, surgical treatment can also be carried out after childbirth. However, it is recommended that patients with severe rectal prolapse undergo cesarean delivery to avoid the excessive strain during natural childbirth, which could worsen the prolapse.

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Colorectal Surgery
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Will rectal prolapse cause the stool to become thinner?

Patients with rectal prolapse may experience a narrowing of their stool, which is primarily due to the relaxation of the rectal mucosa associated with rectal prolapse. The relaxed mucosa accumulates at the anus, blocking the passage of feces and thus altering the shape of the stool as it is expelled, generally resulting in thinner or flattened stools. Therefore, if it is definitively diagnosed that the change in stool shape is due to rectal prolapse, surgical treatment is recommended. The surgery involves excising or suturing the excessively relaxed rectal mucosa to allow for a smoother passage of stool and to prevent alterations in stool shape. Additionally, it is important for patients to maintain good lifestyle and bowel habits post-surgery, spend minimal time defecating, and avoid prolonged squatting or straining actions.

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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.