What is Rectal Prolapse?
Rectal prolapse is a condition in which the rectum (the
lower end of the colon, located just above the anus) turns
itself inside out. In the earliest phases of this condition,
the rectum does not stick out of the body, but as the condition
worsens, it may protrude. Weakness of the anal sphincter
muscle is often associated with rectal prolapse at this
stage and may result in leakage of stool or mucus. The condition
occurs in both sexes, although it is more common in women
than men.
Why does it occur?
Several factors may contribute to the development of rectal
prolapse. It may come from a lifelong habit of straining
to have bowel movements or as a delayed result of stresses
involved in childbirth. In rare cases, there may be a genetic
predisposition in some families. It seems to be a part of
the aging process in many patients who experience weakening
of the ligaments that support the rectum inside the pelvis
as well as loss of tightness of the anal sphincter muscle.
In some cases, neurological problems, such as spinal cord
transection or spinal cord disease, can lead to prolapse.
In most cases, however, no single cause can be identified.
Is Rectal Prolapse the same as hemorrhoids?
Some of the symptoms may be the same. There may be bleeding
and/or tissue that protrudes from the rectum. Rectal prolapse,
however, involves a segment of the bowel located higher
up within the body, while hemorrhoids develop near the anal
opening.
How is Rectal Prolapse diagnosed?
our physician can diagnose this condition by taking a careful
history and performing a complete anorectal examination.
To demonstrate the prolapse, patients may be asked to "strain"
as if having a bowel movement or to sit on the commode and
"strain" prior to examination.
At times, however, a rectal prolapse may be "hidden"
or internal. In this situation, an x-ray examination called
a videodefecogram may be helpful. This examination, which
takes x-ray pictures while the patient is having a bowel
movement, can also assist the physician in determining whether
surgery may be beneficial and which operation may be appropriate.
Anorectal manometry may also be used. This test measures
whether or not the muscles around the rectum are functioning
normally.
How is Rectal Prolapse treated?
Although constipation and straining may be causes of rectal
prolapse, simply correcting these problems may not improve
the prolapse once it has developed. There are many different
ways to surgically correct rectal prolapse.
Abdominal or rectal surgery may be suggested. Your doctor
can help you decide which method will most likely achieve
the best result by taking into account many factors, such
as age, physical condition, extent of prolapse and the results
of various tests.
Treatment of Rectal Prolapse depends on several factors:
How successful is treatment?
Success depends on a number of factors, including the status
of a patient's anal sphincter muscle before surgery, whether
the prolapse is internal or external, the overall condition
of the patient and surgical method used. If the anal muscle
has been weakened, either because of the rectal prolapse
or for some other reason, it may in many cases significantly
regain strength after the rectal prolapse has been corrected.
Chronic constipation and straining after surgical correction
must be avoided. A great majority of patients are completely
relieved of symptoms, or are significantly helped, by the
appropriate procedure.
