Prolapse of the rectum affects a small number of patients, the problem is not common. However, in recent years there has been a trend towards an increase in the disease. Rectal prolapse (this is the name of this ailment) in itself is not life-threatening, except in cases of collapse, but still causes a lot of inconvenience to the patient. Therefore, everyone should be informed, know the symptoms of the disease, and take preventive and treatment measures in a timely manner.
Rectal prolapse - what is it?
In this disease, the lower part of the rectum, which is located slightly above the anus, stretches, becomes mobile and falls out when pressure is applied. Prolapse is most often caused by a weak anal sphincter, which can result in mucus and fecal incontinence. Pictures and photos of rectal prolapse indicate external manifestations of the disease - the rectum with its lower part goes beyondchannel.
The disease always causes physical pain during defecation, psychological discomfort, characterized by sphincter incontinence (blood, mucous discharge). Rectal prolapse is dangerous for both children and adults.
When pathological changes occur, the lower rectum is stretched (its terminal zone), we are talking about a visible area that reaches up to 20 cm in length.
The disease is debilitating, difficult, although not life-threatening. Symptoms reduce the quality of life, which affects the psyche of patients. In proctological diseases, rectal prolapse has a small percentage of the entire list of ailments. It can be diagnosed at any age, even in babies. It is noticed that in men this problem is detected more often. Doctors urge to take the necessary serious preventive measures.
Rectal prolapse: causes
The causes of rectal prolapse are divided into two groups: producing and predisposing.
The first group (producers) includes the following:
- regular straining of the rectum, for example, with frequent constipation;
- complications during childbirth, when the perineum was torn and the pelvic muscles were injured;
- intestinal surgery;
- hard physical work, when the muscular apparatus is constantly tense, intra-abdominal pressure rises;
- sacral region injured in some way;
- ulcers form on the intestinal mucosa.
There are andother causes of rectal prolapse. Photos and pictures confirm the existence of human anatomical features. In these cases, there are predisposing causes:
- pathology of the pelvic muscles;
- sphincter has low muscle tone;
- increased intra-abdominal pressure;
- an indentation in the rectum;
- stretching of the intestinal muscles;
- intestinal lengthening, mesentery;
- Coccyx is vertical;
- difficult pregnancy, difficult delivery.
Doctors pay special attention to pathologies that arise in connection with non-traditional sexual preferences. A provoking factor in the occurrence of rectal prolapse can be constant painful stimulation of the anus. As a result, not only pain occurs, but also prolapse of the rectum.
Types and stages
By its typology, this disease has the following variants:
- Prolapse is determined by the downward displacement of the anterior wall - this is a hernial variant. Occurs with weak pelvic muscles, with an increase in intra-abdominal pressure. The mucosa of the rectum is pressed through and brought out at the same time.
- Inside the mucosa of the anus, a part of the sigmoid or rectum is pressed in, there is no output beyond - this is an invagination option.
According to the basic mechanisms of the development of the disease, proctologists distinguish stages of the disease (degrees) in rectal prolapse:
- Compensated minor stage. During the process of defecationslight bowel inversion. At the end of the stool process, the intestine returns to its original position on its own.
- Subcompensated, deeper stage. The intestine falls out, as in the first case, however, it returns to its original position slowly, and pain syndromes and bleeding occur.
- Decompensated, stressful stage. Rectal prolapse is not only in the process of defecation, but also with any intra-abdominal pressure, tension, while the intestine does not reset itself. Bleeding often occurs, fecal incontinence, gases are possible. The sphincter is in a relaxed state for a long time.
- Decompensated deep, permanent stage. With any physical activity, in any position (sitting, standing), prolapse of the intestine occurs. Necrotic processes developing on the mucous membrane cause bleeding, itching, pain.
Symptoms and signs of the disease, complications
The development of the disease can occur at a slow pace, or it can occur suddenly. Most often, prolapse develops gradually. At first, prolapse of the intestine can be observed only during defecation. With the progression of the disease, it is necessary to set the place that falls out at any voltage.
Sudden prolapse can provoke a sharp jump in intra-abdominal pressure during strong physical exertion. With a sharp fall, severe pain occurs, which can cause a state of shock and even collapse.
Rectal prolapse symptoms:
- in the anusthere is a sensation of a foreign body;
- frequent false urge to defecate;
- constant pain in the anus;
- disappears the ability to contain feces and gases.
When the intestine prolapses, bleeding occurs, the vessels are injured. If there are at least some signs of rectal prolapse, treatment with folk remedies is unlikely to help you. Seek qualified medical attention immediately. With a belated intervention, there may be manifestations of problems with the urinary system, there is an infringement of the rectum.
Dangerous consequences of rectal prolapse can be:
- intestinal obstruction;
- peritonitis.
The body's immune defenses are sharply reduced, a person loses his ability to work. The nervous system is in constant tension, the patient is irritable, suffers from apathy and neurosis.
Diagnosis
When diagnosing rectal prolapse, the doctor should study the medical history in detail and examine the anorectal area. It should be noted that external manifestations are visible only in advanced stages. Initially, the disease is not visualized. The patient is invited to strain in the "squatting" or "stool" position. When the bowel appears, the diagnosis is confirmed. A digital examination can be used, for this the patient is located in an examination chair. On examination, the doctor evaluates the muscle tone and elasticity of the anus. If, when straining, the volume of the rectum increases sharply, then this indicatesdisease.
To determine the degree of rectal prolapse, defecography is prescribed. During the procedure, an act of defecation is simulated, while radiographic images are taken, according to which the doctor will determine the severity of functional and anatomical disorders, determine the methods of surgical intervention.
Anorectal manometry will help evaluate the functioning of the muscles that are located around the intestine, as well as assess their role in the process of defecation.
Also used in the diagnosis of instrumental methods such as colonoscopy, sigmoidoscopy. Each method, when making a diagnosis, helps to complete the picture of the disease, to clarify the stage of development of the disease.
Conservative treatment
The method of treatment of rectal prolapse is based on the indicators of examination, diagnosis. The doctor must define specific medical tasks. Treatment measures can be divided into two main areas: conservative and surgical.
If a diagnosis of "rectal prolapse" is established, treatment with conservative methods is justified only in the first stages of the disease. It is more often prescribed to young or middle-aged patients. The main objectives of conservative treatment will be to eliminate the causes that led to the development of prolapse. This includes:
- Identification and treatment of all pathologies that are found in the colon.
- Stool normalization.
- Be sure to eliminate constipation.
- Exclusion of all physical activity, lifting of any weights, loads.
- Sex life should be safe (deleteany stimulation of the anal passage).
It is very important for the patient to choose the right physical education, which would be performed daily and strengthen the muscles of the pelvic floor and perineum.
Also conservative treatment may include:
- sclerosing drugs (injection course);
- rectal massage;
- physiotherapy (electrical stimulation).
Conservative treatments can help only in the early stages of the disease (only 2/3 of cases). Most often, the patient requires surgery.
Surgical treatment
Methods of surgical treatment of rectal prolapse are becoming more complicated and improved every year. To date, there are about fifty methods of intervention. The choice is determined depending on the task. Carrying out this or that operation depends on the following factors:
- degree of disease development;
- individual anatomical features;
- age of patient;
- well-being.
The main areas of surgery are:
- Removal of a prolapsed portion of the rectum.
- Removal of a specific affected area of the colon.
- Complex of plastic measures. The rectum is stitched, the possibility of adjusting some of the pelvic muscles in the intestinal canals.
- Combination of several methods of surgical intervention.
Modern proctologists often practice the method of suturing the rectum, while it is less injured. patient easytolerates intervention, and recovery from rectal prolapse surgery is short.
There is also an improved bloodless method for the treatment of prolapse - laparoscopy. The recovery period is accelerated, the risks of complications are minimized.
For most operated patients, the prognosis is very positive:
- Elimination of symptoms.
- Full recovery.
- Better quality of life.
- Elimination of psychological trauma.
After surgery, the performance of the anal sphincter gradually returns to normal, the tone improves, the functions are restored. The specific results of treatment can be judged after a year.
Prevention
Measures to prevent rectal prolapse are quite simple. In order not to lead to a pathological condition, it is necessary to eat right: eat more vegetables, fruits, herbs, fiber, include less in the diet (and it is better to exclude) semi-finished products, smoking, pickles. In general, nutrition should contribute to the smooth functioning of the digestive tract (gastrointestinal tract) and the correct act of defecation.
Treat any rectal disease that could lead to prolapse promptly. Engage in physical therapy, do exercises that strengthen the muscles of the pelvic floor. From childhood, teach children to go to the toilet correctly, not to push hard and not to sit for a long time on the potty.
Beware of any physical overload that leads to an increase in intra-abdominal pressure.
Bas a preventive measure, proctologists do not recommend engaging in any type of anal sex.
Disease in children
Rectal prolapse in children occurs most often between the ages of 1-4 years. In boys, this pathology occurs more often (ratio two to one). Prolapse occurs due to any complications after gastrointestinal diseases, while intra-abdominal pressure increases. Factors that contribute to rectal prolapse:
- Atrophy of adipose tissue, as a result, weak fixation of the intestine.
- Sagging of the perineum is congenital.
- Hypotrophy, rickets.
- Constipation, diarrhea.
- Dysentery.
- Long stay on the potty.
- Anatomical features.
- Complication of hemorrhoids.
You should also pay attention to genetic predisposition, type and diet, previous diseases, possible dystrophic changes.
It is not easy to notice the initial symptoms in a child. With the act of defecation, the mucosa can turn out of the passage and immediately return to its natural position. To detect a problem, parents should examine the child's anus during stool for a red rosette that falls out of the anus. If you find a problem, you should immediately contact the doctor.
If there is no treatment, the disease may progress. With the development of muscle hypotonia, the rectum will begin to fall out with each bowel movement. In these cases, it will no longer be able to self-adjust, it will have to be done manually. With further developments of the pathology, prolapsecan occur in a child with any straining, coughing, crying, laughing. Due to the weakness of the muscle sphincter, fecal incontinence may occur. Infringement of the intestine can threaten not only the he alth, but also the life of the baby, in this case, only surgical intervention will help.
Treatment of rectal prolapse in children
Methods of treatment of rectal prolapse in children in the early stages are based on conservative and sclerosing therapy. The objectives of conservative treatment are:
- Elimination of constipation.
- Diet therapy with the inclusion of fiber.
- Restoration of the digestive tract.
- Defecate only while lying down (on your back or on your side). Sitting prohibited.
- Control bowel prolapse.
- Strict hygiene behind the anus.
- Properly selected medications should eliminate inflammation in the intestinal mucosa.
If conservative methods do not help, resort to sclerotherapy.
The technique is based on the introduction of a sclerosing substance into the fiber, which will be localized near the rectum. As a result of the effect of the drug, diseased, atrophied tissues will be replaced by scar and connective formations. The rectum will be firmly fixed. The technique is rarely used, it is painfully tolerated by the child, sometimes it can cause complications.
To prevent prolapse in children, it is necessary to monitor their proper nutrition from an early age, to exclude the appearance of constipation. Teach your child quicklydefecate, do not sit on the pot for a long time.
