Can rectal prolapse cause bleeding during bowel movements?

Written by Deng Heng
Colorectal Surgery
Updated on December 13, 2024
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Patients with rectal prolapse may experience bleeding during bowel movements. The primary symptom of rectal prolapse is a protrusion of a swelling through the anus. Initially, the swelling is small and only protrudes during bowel movements, retracting on its own afterwards. As the condition progresses, due to a lack of contraction strength in the levator ani and anal sphincter muscles, the prolapse occurs more frequently and increases in size, requiring manual repositioning back into the anus after defecation. If not repositioned timely, the prolapsed intestinal tract can become edematous, constricted, or even necrotic, which may result in bloody stools.

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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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Rectal prolapse treatment

Rectal prolapse is primarily categorized into mild rectal prolapse as well as moderate and severe rectal prolapse. Mild rectal prolapse generally occurs in the early stages of the illness or in children and can be treated conservatively. Conservative treatment mainly involves Chinese herbal retention enemas. On the other hand, moderate and severe rectal prolapse can result in the protrusion of the local mucosa outside the anus, presenting as cylindrical or cone-shaped prolapses. Treating moderate to severe hemorrhoidal prolapse requires surgical intervention. The main surgical methods include hemorrhoidal mucosectomy with stapling and local submucosal sclerosant injections. It is also important to caution postoperative patients against squatting for long periods or straining during constipation, as these actions can exacerbate symptoms of submucosal prolapse.

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Written by Chen Tian Jing
Colorectal Surgery
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What is the pathogenic mechanism of rectal prolapse?

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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Colorectal Surgery
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Can people with rectal prolapse eat beef?

Patients with rectal prolapse can eat beef, but it is not recommended to consume it in excess, as eating too much beef may lead to dry stools or a high fiber content in the feces, making it difficult to expel and potentially worsening the severity of the rectal prolapse. The diet for patients with rectal prolapse should mainly be light, including liquid or easily digestible foods, and avoid spicy foods like chili peppers and seafood or foods with a hard texture. In addition to dietary considerations, patients with rectal prolapse also need treatment to relieve symptoms or cure the condition. Options include traditional Chinese medicine enemas that preserve the function or oral medications that supplement and boost vital energy, as well as surgery to remove the prolapsed rectal mucosa.

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Colorectal Surgery
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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.