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Rectal Prolapse

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Introduction

Although the symptoms may not always be evident, piles are a common medical condition that occurs in many people. Several effective treatment options are available for piles, and most people get relief from symptoms with lifestyle changes and home remedies.

What is Rectal Prolapse?

The rectum is the lowermost part of the large intestine. It eliminates digestive waste through the muscular opening of the digestive system called the anus. Rectal prolapse occurs when the rectum slips out of the anus. Smiles Gastroenterology has rectal prolapse treatment doctors in Bangalore, who provide the best treatment that works for you best.

Based on the degree of prolapse, it may be classified into:

  • Internal prolapse: The rectum begins to slip but doesn’t distend across the anus yet.
  • Partial prolapse: Part of the rectum prolapses through the anus.
  • Complete prolapse: Rectum completely extends out of the anus.

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What Causes Rectal Prolapse?

Several factors may cause a prolapsed rectum:

  • ● Chronic constipation leads to straining during bowel movements. Over more extended periods, straining can push the rectum down towards the anus to cause a prolapse.
  • ● With aging, the muscle and ligaments supporting the rectum weaken, resulting in prolapse.
  • ● The weakening of the anal sphincter. The anal sphincter controls the elimination of stool through the anus. Weak sphincter muscles can also cause the portions of the rectum to slip through.
  • ● Previous injury to the anus or pelvic floor.
  • ● Nerve Damage. If the nerves connecting to the rectal and anal muscles are damaged, it could result in rectal prolapse. Nerve damage may be caused by pregnancy, difficult vaginal childbirth or spinal injuries.
  • ● Rectal prolapse can result from other medical conditions such as hysterectomy, previous colorectal surgeries, abdominal surgeries, diabetes, and infections in the intestines.

What Are the Symptoms of Rectal Prolapse?

Rectal prolapse occurs over time, gradually developing symptoms. The most prominent sign of a prolapsed rectum is the bulging of your anus. During the initial stages, you may find a reddish bulge during bowel movements. It retreats on its own. Eventually, it may occur even during activities like exercises, walking, and coughing.
As the prolapse worsens, you may experience bleeding from your rectum.
Episodes of constipation and bowel incontinence are prevalent in most people with rectal prolapse. Bowel incontinence means difficulty in controlling stools: liquid and solid. You may also experience gas escaping from your bowels frequently due to incontinence.

How is Rectal Prolapse Diagnosed?

In case you experience any of the symptoms, consult your doctor rather than waiting for the prolapse to worsen. The rectal prolapse treatment doctors in Bangalore at Smiles Gastroenterology will look over your medical history in detail and ask about your symptoms. You will also have to undergo a physical exam, which may include a rectal exam.

Your doctor may also advise a colonoscopy to rule out other medical conditions like polyps or colorectal cancer.

How is Rectal Prolapse Treated?

Rectal prolapse does not cure on its own. With time, the prolapse will worsen, causing an increase in symptoms. The time duration for the prolapse to worsen may vary from months to even years. If you have a prolapsed rectum, you can delay the treatment. However, do so only if your symptoms are mild and don’t hamper your quality of life. If the symptoms worsen, treatment is advisable. The only effective treatment for rectal prolapse is surgery. Surgery for rectal prolapse can repair the damage and help relieve your symptoms.
Surgery involves two primary approaches: abdominal or through the anus. Your surgeon will choose the method based on your health status.

  • Laparoscopic Surgery for Rectal Prolapse : The surgery involves smaller incisions through which the surgeon inserts surgical instruments and a camera to pull the rectum back to its original place.
  • Abdominal Approach for Rectal Prolapse Repair : Rectal prolapse repair through large incisions in the abdomen requires a mesh sling insertion to anchor the rectum. If you have a history of constipation, removing a part of the colon during the surgery can help with your complaints.
  • Perineal Rectosigmoidectomy This surgery involves the repair of the prolapse through the anus. The surgeon will remove the prolapsed part of the rectum via the anus. They will then pull back the remaining portion of the rectum and attach it to the intestine. The approach is beneficial for people who are unable to undergo laparoscopic or abdominal surgery.

What Are the Results?

The prolapsed rectum may be painful, but it is easy to treat. With a rectal prolapse surgery, the outcome is positive.

    • Following the surgery, you will be on a special diet consisting of soft foods and liquids. You may also need to take stool softeners in the initial period following surgery to prevent constipation. Straining during bowel movements can hamper the healing process.
    • Although the healing process after the surgery depends on individual factors like underlying health status, you may require around 6-8 weeks for complete recovery.

What Are the Risks of Surgery?

Rectal prolapse surgery has several risks. They include:
    • ● Internal bleeding
    • ● Bowel obstruction
    • ● Injury to surrounding structures – organs and blood vessels
    • ● Anal narrowing
    • ● Site Infection
    • ● Fistula — an abnormal connection between two body parts, such as the rectum and vagina
    • ● Recurrent prolapse
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    FAQ's

    How does Rectal Prolapse Look?

    In Rectal Prolapse, you may notice a reddish, fleshy mass protruding from the anus. Initially, it may occur temporarily on straining when defecating. But as the condition progresses, you will notice a more prominent bulge.

    Can Rectal Prolapse Heal Itself?

    Rectal Prolapse, in its early stages, can recover and correct under medical attention. However, for severe cases, Rectal Prolapse surgery may be necessary.

    Can you Defecate with a Rectal Prolapse?

    Constipation and bowel incontinence are the most common complaints of people with Rectal Prolapse. Although you can defecate with rectal prolapse, it will not be without difficulties.

    What Happens if the Prolapsed Rectum is left Untreated?

    Untreated Rectal Prolapse can progressively worsen over time. It can lead to ulcers and bleeding from the rectum. Also, the blood supply in the rectum may reduce due to the prolapse. Severe blood restriction can cause gangrene and death of the rectum tissue.

    How do I know if my Rectal Prolapse is Severe?

    If you have problems controlling your bowel movements or experience rectal bleeding, your Rectal Prolapse is worsening.

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