Prolapse of the rectum is an extremely unpleasant pathology, which is accompanied by a displacement of the distal parts of the rectum and its exit beyond the anal sphincter. This problem is most often faced by people of young and mature age. The disease is not uncommon in pediatric practice.
Of course, many people are looking for any information about the disease. Why is rectal prolapse dangerous? Symptoms, causes, treatment, possible complications - this is important information that should not be overlooked. So, when should you see a proctologist?
Rectal prolapse: ICD-10 general information
Many people are looking for information about this disease. Rectal prolapse (ICD - 10 assigned the code K62 to this pathology) is a pathology that is accompanied by a displacement of the distal (lower) colon, as a result of which a small fragment of the intestine comes out through the anal sphincter. The length of the segment that falls out can vary from 2 to 20 centimeters, depending onstages of development of the disease.
Prolapse of the rectum is often diagnosed in children aged 3-4 years, which is associated with the anatomical features of the growing organism. The risk group is young and mature people under the age of 50. By the way, according to statistics, 70% of patients with a similar diagnosis are men.
Main causes of disease
Causes of rectal prolapse can vary and are worth checking out.
- There is a hereditary predisposition.
- Constant tension of the abdominal wall and pelvis during bowel movements. This is observed during bowel movements.
- Potentially dangerous are salmonellosis, dysbacteriosis, enterocolitis, dysentery and other diseases that are accompanied by prolonged diarrhea.
- Prolapse of the rectum in women is often the result of birth trauma, perineal rupture, complications during pregnancy.
- Some pathologies of the rectum, in particular, hemorrhoids, can lead to a similar result.
- Prolapse often develops in people with congenital anatomical features (for example, an elongated sigmoid colon is considered a risk factor).
- The development of such a pathology can lead to lifting weights, intense physical activity (professional athletes often face such a problem).
- Potentially dangerous are various neuralgic disorders, brain injuries and tumors, impaired innervation of the pelvic muscles and sphincter, inflammationnerve structures.
Risk factors
There are factors that increase the likelihood of rectal prolapse (if there are prerequisites, of course). Their list is quite impressive:
- diseases of the digestive tract, in particular, the formation and growth of polyps, chronic diarrhea, etc.;
- pathologies of the genitourinary system, for example, urolithiasis, inflammation of the prostate in men;
- decrease in sphincter tone, weakening and stretching of ligaments (such changes are a natural part of the aging process);
- disorders of the pelvic organs, blood stasis;
- excessive interest in non-traditional types of sexual intercourse (anal sex is always associated with the risk of damage to the rectum);
- neurological diseases that affect the spinal cord;
- a similar pathology in infants sometimes develops against the background of diseases accompanied by a strong cough (risk factors include whooping cough, bronchitis, pneumonia).
What symptoms appear on the background of the disease?
Symptoms of rectal prolapse may be different, since the features of the clinical picture directly depend on the degree and stage of development of the pathology.
- Often, patients complain of pain in the lower abdomen, the appearance of which is associated with the tension of the mesentery. Soreness increases during walking, running, physical exertion. If the intestine is set, then the patient's well-being improves,but only temporarily.
- Sometimes only a small portion of the mucous membrane falls out during tension of the abdominal wall. But in more serious situations, a fragment 8-10 cm long, and sometimes even 20 cm long, falls outside the sphincter - the process is accompanied by very unpleasant sensations that simply cannot be ignored.
- A person is constantly tormented by the feeling of a foreign body in the anus, which is associated with displacement of the mucous membrane and other tissues.
- There are problems with the stool. For example, many patients complain of frequent urges that do not end with a bowel movement despite best efforts. In addition, a sick person is tormented by constipation, as well as a feeling that the intestines are not completely emptied. Some people complain of chronic constipation, which only aggravates the situation. In the later stages of the development of the disease, involuntary defecation is possible.
- Displacement of the structures of the large intestine also affects the functioning of the genitourinary system. Many patients report frequent urination, and sometimes complain of a feeling of a constantly filled bladder. In later stages, urine leakage may occur.
- Prolapse of the rectum in women is often associated with prolapse or prolapse of the uterus.
- Quite often, the disease is accompanied by the appearance of mucous secretions, sometimes with an unpleasant odor. Small bleeding is also possible, which is associated with trauma to the intestinal mucosa during defecation.
Noticing such violations, it is very important to see a doctor. Unfortunately, about such a delicate issue, people preferkeep silent, therefore, a specialist is addressed already at the later stages of the development of the disease.
Degrees and stages of fallout
Diseases of the anal canal and rectum - the group to which this pathology belongs according to ICD-10. Signs of rectal prolapse directly depend on the stage of development of the disease. To date, there are four main stages.
- In the first stage, prolapse occurs only during defecation. Immediately after emptying, the direct cyst returns to its place on its own.
- The second stage is accompanied by more pronounced symptoms. Prolapse of the rectal mucosa, as before, occurs during emptying. The bowel itself falls into place, but it happens very slowly. During this stage, patients are more likely to experience discomfort. Minor bleeding may occur.
- In the third stage, rectal prolapse already occurs during physical exertion, in particular, weight lifting. The mucous membrane is no longer repositioned on its own.
- The fourth and final stage is accompanied by almost constant loss. The rectum moves through the anus during laughter, talking, walking. At this stage, necrosis of the intestinal mucosa begins.
There are four degrees of rectal prolapse in humans:
- I degree - only prolapse of the mucous membrane is observed (it is slightly everted during bowel movements).
- II degree - all layers of the anal rectum fall out.
- III degree - there is a complete prolapse of the rectum.
- IV degree - the entire rectum falls out and even the sigmoid area.
Of course, the choice of treatment methods directly depends on the degree and stage of development of the pathology. If conservative therapy is still possible at the initial stages, then only surgical intervention can help in the later stages.
Possible Complications
Prolapse of the rectum is an extremely unpleasant and dangerous disease that should not be ignored. If left untreated, the disease can lead to infringement of the intestine. There is a possibility of developing intestinal obstruction, and in more severe cases, peritonitis.
If we are talking about the last stages of the development of the disease, then the beginning of a necrotic process is possible. If untreated, the pathological process can spread to other parts of the digestive tract. In such cases, the risk of gangrene is high - if left untreated, the disease can result in the death of the patient.
Of course, constant soreness, fecal incontinence, increased gas formation and other symptoms affect the emotional state of the patient. The person feels constrained, does not sleep well, has difficulty communicating, becomes withdrawn, and sometimes antisocial.
Diagnostic measures
Of course, diagnosis is very important in this case. The doctor needs to determine the degree and stage of development of the disease, and, if possible, find out the causes of the pathology.
- First of all, the specialist conducts a survey, collects information for compilinghistory, is interested in the presence of certain symptoms and the circumstances of their occurrence.
- In the future, an external examination is carried out. It is very important to differentiate this disease from hemorrhoids. Prolapse of the rectum is characterized by the formation of transverse folds of the mucous membrane. But if during the examination and palpation the doctor noticed that the folds of the intestinal mucosa are longitudinal, then this may indicate hemorrhoids. During the examination, the doctor evaluates not only the relief, but also the tone of the mucosa. Sometimes the patient is asked to strain in order to determine at what point the prolapse occurs.
- Intestinal x-rays are also being done.
- Retromanoscopy and colonoscopy are mandatory. With the help of special equipment, a specialist can carefully examine the mucous membrane of the large intestine, detect damage and neoplasms. If necessary, during the examination, the doctor performs a biopsy - tissue samples are then sent for laboratory analysis.
- A procedure such as anorectal manometry helps evaluate the functioning of the anal sphincter.
- Women with a similar problem are also sent for gynecological examinations.
Conservative Therapy
How to treat rectal prolapse? Only a doctor can answer this question. Much here depends on the degree and stage of development of the pathology.
- The rectum can be reset, but this is only a temporary measure. In the future, doctors recommendexclude contact with risk factors. It is important, for example, to avoid certain types of physical activity. Doctors give patients laxatives to help prevent constipation. It is worth giving up non-traditional sexual contacts.
- The muscles of the perineum nevertheless need to be strengthened, so patients are recommended special therapeutic exercises. The exercises are very simple, but you need to remember that they should be repeated daily. Physiotherapists recommend alternately tightening the muscles of the anal sphincter and perineum. Raising the pelvis while lying on the floor is also an effective exercise.
- Patients are also recommended various physiotherapy. For example, the pelvic floor muscles are stimulated with an electric current, which improves their tone. Correctly performed rectal massage improves blood circulation, strengthens muscles and has a beneficial effect on bowel function.
It should immediately be said that such treatment is possible only in the initial stages and only if the patient suffers from a mild degree of prolapse for no longer than three years. Otherwise, all of the above methods will not give the desired result.
Rectal prolapse: surgical treatment
Immediately it should be said that the operation today is the only really effective method of therapy. To date, there are many procedures to help eliminate the defect of the rectum.
For example, it is possible to resect a prolapsed portion of the rectum, plastic surgery of the analsphincter and pelvic floor muscles, "suspension" of the distal part of the intestine, etc. In most cases, combined operations are performed, during which the affected part of the organ is removed, after which plastic correction is performed to preserve the basic functions of the intestine. Surgery is generally well tolerated by patients. Massive resection is required only for gangrene.
Surgeries can be performed laparoscopically, as well as through an incision in the abdominal wall or perineum - it all depends on the degree of complexity of the procedure, the presence of certain complications.
What can traditional medicine offer?
Many patients are interested in questions about whether it is possible to treat rectal prolapse at home. Of course, folk healers offer a lot of recipes. But it should be understood that all home remedies are intended only to eliminate the main symptoms and prevent complications. Decoctions and infusions of herbs will not help eliminate the existing loss.
- Herbal, sitz baths are considered effective. To prepare a decoction, you will need to mix 50 g of sage, meadowsweet and knotweed. We mix all the ingredients and pour a liter of boiling water. After the infusion has cooled, it can be filtered and added to bath water. It is desirable to carry out the procedure daily. The medicine helps relieve swelling and inflammation of the mucous membrane, get rid of itching and discomfort.
- Fresh quince juice has healing properties. In it, you need to moisten a clean napkin and apply it for 10-15 minutes toanus area. It is believed that this procedure helps to cope with pain.
- Calamus root also has anti-inflammatory properties. A tablespoon (incomplete) of crushed, dried roots should be poured with a glass of cold water. The agent is infused for 12 hours, after which it is heated (not boiling) and filtered. It is recommended to drink 2-3 tablespoons of medicine after meals.
- Chamomile helps to cope with pain and swelling. Its decoction is often added to sitz baths. In addition, pore procedures are also effective. Hot broth should be poured into a wide container and squat over it. It is worth noting that the medicine should not be too hot (steam can burn the skin) or too cold (steam should rise from the liquid).
- Decoctions of their oak bark are also used for sitz baths.
- Effective is the tincture of their shepherd's purse (you can cook it at home or buy a ready-made product at the pharmacy). The liquid should be periodically treated with the anus area - this helps to get rid of discomfort, relieve inflammation and prevent secondary infection.
Of course, before starting therapy at home, you need to consult a doctor. The use of herbal medicines is not at all a reason for refusing full-fledged conservative therapy and surgical intervention.
Prognosis for patients
Immediately it should be noted that only surgical treatment of rectal prolapse is truly effective. Properly performed surgery allows you to restore the functions of the colon by at least 75%. The likelihood of relapse is small, especially if the patient follows medical recommendations (we are talking about the right diet, timely treatment of constipation and diarrhea, etc.).
Prevention
The development of such a disease can be prevented. Prevention of rectal prolapse includes the following activities:
- regular physical therapy, in particular, exercises aimed at strengthening the muscles of the anus and perineum;
- timely treatment of chronic constipation and diseases of the respiratory system, which are accompanied by a strong cough;
- following the right diet (the diet should include foods rich in fiber);
- correct drinking regimen (at least 2 liters of water per day).
When the first symptoms appear, you need to see a doctor. The sooner the problem is detected, the sooner adequate treatment will begin, the lower the likelihood of complications.
