rectal prolapse

Rectal prolapse is a condition where part (or all) of the rectum slips down through the anal opening, turning inside out. It may start as a temporary issue but can become chronic if left untreated. 🔍 Types of Rectal Prolapse Complete (Full-Thickness) Prolapse The entire rectal wall protrudes through the anus Visible outside the body, especially after straining Mucosal Prolapse Only the inner lining (mucosa) of the rectum comes out More common in children Internal Prolapse (Intussusception) The rectum folds into itself but doesn't exit the anus May cause obstructed defecation (linked to ODS) ✅ Symptoms Bulging tissue from the anus (especially after straining or bowel movements) Sensation of something “falling out” Mucus or stool leakage (incontinence) Rectal bleeding or irritation Pain or discomfort during bowel movements Constipation or feeling of incomplete emptying 📌 Risk Factors Chronic constipation or straining Long-term diarrhea Aging (more common in adults over 50) Weak pelvic floor muscles History of multiple childbirths (in women) Neurological conditions (e.g. spinal cord injury, multiple sclerosis) Prior rectal surgery 🧪 Diagnosis Physical exam (ask patient to strain or bear down) Defecography (X-ray or MRI) – visualizes prolapse Colonoscopy or sigmoidoscopy – rules out cancer or polyps Anorectal manometry – evaluates muscle function 💊 Treatment 🔹 Non-Surgical Management (for mild cases or those unfit for surgery) Stool softeners, high-fiber diet, and hydration Avoid straining or prolonged sitting on the toilet Pelvic floor therapy or biofeedback (for internal prolapse or associated dysfunction) ⚠️ Non-surgical methods don’t reverse the prolapse but can help manage symptoms. 🔧 Surgical Treatment – Often Required for Lasting Relief Approach Description Common Procedures Abdominal surgery Rectum is pulled up and secured to the sacrum Rectopexy (with or without sigmoid resection) Perineal surgery Done through the anus; less invasive, good for elderly or high-risk patients Delorme procedure, Altemeier procedure Minimally invasive options (laparoscopic or robotic) are now common Surgery choice depends on age, overall health, and type/severity of prolapse 💡 Post-Treatment Care Prevent constipation (fiber, fluids, movement) Avoid heavy lifting or straining Continue pelvic floor exercises if advised Monitor for recurrence or incontinence 🚨 When to Seek Immediate Help Prolapse that can’t be pushed back in Severe pain, bleeding, or discoloration of rectal tissue (could mean strangulation) Fever or signs of infection