Rectal Prolapse

The rectum is a section of the large intestine that is present at its very end. It is that portion of the digestive tract where stools are stored before they are processed by the body. You can feel the desire to defecate after the faeces reaches the rectum. The stool is pushed out of the anus by a set of muscles. If the rectum protrudes out with the stool, this anomaly is known as rectal prolapse.

Any body part that has moved out of its natural place in your body is referred to as having prolapsed by medical professionals. Usually, it denotes a deterioration or weakening of the muscles that support the part. With age, there will inevitably be some degradation or weakening; however, the additional muscular strain might hasten this process. Rectal prolapse is more prevalent in women than in males, and it typically affects those over the age of 50 or those who have a history of persistent constipation or diarrhoea.

Who is susceptible to rectal prolapse?

• Women experience it six times more frequently than males. Women over 70 years old have the highest incidence, which rises with increasing age. Younger men often have a higher risk of getting rectal prolapse.
• Rectal prolapse has no specific cause; however, in many cases, it is shown to be related to persistent constipation.
• Rectal prolapse has been linked to multiple childbirths through regular vaginal deliveries. About one-third of women with rectal prolapse do not mention their history of vaginal birth, though.

What causes rectal prolapse?

Rectal prolapse happens when the muscles that keep the rectum in place fail to do so. This might be caused by several factors. Many possibilities include the following:

• Ageing
• Cystic fibrosis.
• Pregnancy and childbirth.
• Pelvic injury or surgery in the past.
• Diarrhoea or chronic constipation.
• Nerve or spinal cord injury.
• Persistent sneezing or coughing.
• Parasitic infections in the intestines.

What are rectal prolapse’s obvious signs or symptoms?

People who have rectal prolapse may experience the following signs:

• Patients may have a feeling of tissue bulging out of the anus. Manually pushing the tissue back inside could or might not be possible. The most common way that patients report this is as “something dropping out” while passing stools.
• A sensation that something is still lodged in your anus after you defecate. Some patients may need to use the restroom more than once per day and may feel as though their excretion was incomplete.
• Mucus flow from the anus may occasionally occur along with the prolapse.
• Constipation or faecal incontinence may occur in some people.
• Occasionally, an ulcer may form on the prolapsed mucosa. It could also get imprisoned, making it impossible to force it back into the anal canal. This illness can cause excruciating pain and may necessitate urgent surgery.
• Rectal prolapse can occasionally be mistaken for piles. So, if you have any of the aforementioned symptoms, please see a surgeon for a comprehensive examination.

How is rectal prolapse diagnosed?

After going through your medical history, the top doctors at Apollo Hospitals, Karnataka, will evaluate your rectum. A gloved and lubricated finger may be inserted into the anus during the physical examination to test the rectum and anal sphincter’s strength. The purpose of this assessment is to help the doctor better understand the condition; thus, you will be asked to detail your symptoms and medical background.

At Apollo Hospitals, Karnataka, the doctor may ask you to undergo further testing for precise diagnosis:

• Anal Electromyography (EMG) – This test establishes whether nerve injury is to blame for the anal sphincters’ dysfunction. Moreover, muscular coordination is tested.
• Colonoscopy – A flexible scope is used in this test to see within your large intestine.
• Lower GI Series (Barium enema) – A number of video X-rays of your lower digestive system.
• Defecography – Using an X-ray or MRI, this imaging evaluation of your muscles during bowel movements.
• Anorectal Manometry – Your anal sphincters’ strength and tightness are evaluated during this test.

To check for weak spots in the pelvic floor and determine whether other organs, such as the uterus, have prolapsed as well, the doctor may occasionally advise doing certain gynaecological or urological checks

What is the treatment of rectal prolapse?

The most common form of treatment for rectal prolapse is surgery. Stool softeners, suppositories, and other medications are among the numerous treatments for constipation. For the surgical treatment of rectal prolapse, there are several options. Based on your age, physical health, and bowel function, your doctor will choose the best course of action for you.

Types of Rectal Prolapse Surgery

There are various surgical techniques that can be used to treat rectal prolapse. Depending on the nature of your condition, you may need to undergo surgery. The following procedures are the most often used to treat rectal prolapse:

• Rectopexy or Rectal Prolapse Surgery through the Abdomen
• Laparoscopic rectal prolapse surgery
• Robotic surgery
• Perineal Rectosigmoidectomy
• Delorme Procedure

What potential risks or complications might arise after rectal prolapse surgery?

The likelihood of problems following rectal prolapse surgery is relatively low, and the majority of patients do not have adverse side effects. Every operation, though, carries some possible hazards that you should be aware of. Surgery for rectal prolapse has several complications, such as:

• Infection
• Constipation
• Bleeding
• Blood clots
• Damage to the surrounding organs
• Anaesthesia-related allergic response
• Sexual dysfunction

What can I do to prevent Rectal prolapse from developing or returning after surgery?

• Address bowel conditions that are persistent. Avoid persistent diarrhoea or constipation. Inquire with your healthcare professional about available treatments, such as dietary adjustments and medications.
• Boost the strength of your pelvic floor. Your pelvic muscles may stay healthy and powerful by performing kegel exercises. They have been proven to stop both incontinence and potential pelvic organ prolapse.

What is the prognosis for Rectal prolapse?

Constipation might not seem like a big deal at first, but it’ll only become worse with time. You should probably visit your doctor as soon as possible if you already have gastrointestinal issues. Rectal prolapse is often corrected by surgery; however, it might recur in a small percentage of cases. A combination of other treatments may be required to resolve the recurrence.

Rectal prolapse is a proctological disorder that results in consequences such as the rectum being strangled, bleeding, and ulceration. Thus, prompt and highly effective treatment is crucial. At Apollo Hospitals, Karnataka, we provide cutting-edge surgical procedures to cure rectal prolapse and assist patients in finding relief from the suffering this problem causes. We have state-of-the-art equipment, facilities, and infrastructure, as well as a team of highly skilled doctors, surgeons, and healthcare professionals that deliver excellent treatment results.