|
A rectal prolapse occurs when the rectum becomes dislodged from its usual
position and protrudes from the anus. There are three types of rectal
prolapse: Mucosal or partial prolapse occurs when only the mucosal lining is
protruding, complete prolapse indicates that the entire wall of the rectum
is protruding, and internal intussusception occurs when the rectum and
sometimes part of the intestine collapse like a telescope. Rectal prolapses
are most common in the very young (usually due to another medical condition)
and older adults. Rectal prolapse is more common in women due to the
stresses on the supporting muscles and ligaments associated with
childbearing.
Rectal prolapse risk factors include conditions associated with straining,
structural deformation and reduced muscle tone. Straining and irritation of
the rectum can occur due to long term constipation or diarrhea. Age
decreases the strength of the pelvic floor muscles, as does childbearing and
childbirth. People with reduced muscle tone due to paralysis or other
medical conditions are also at increased risk. Certain malformations of the
intestinal tract or surgeries on the intestines, internal reproductive
organs or spine can also predispose a person to rectal prolapse. Hemorrhoids
are a risk factor for prolapse, but the prolapse of hemorrhoids is also
often confused with actual rectal prolapse. High fiber diets and sufficient
fluids reduce the risk somewhat.
Rectal prolapse generally starts with mucosal prolapse. A section of the
rectal mucous membrane shifts and protrudes from the anus, usually during a
bowel movement. Usually the prolapse will slide back into the anus on its
own at first, but eventually it may start to protrude during other
activities that activate the pelvic floor such as sneezes and coughs. If
allowed to progress, the prolapsed portion may remain out of the anus all
the time and develop to a complete rectal prolapse. The affected person may
have discomfort and irritation in the affected tissue or a feeling of full
bowels. Membranes rubbing together can lead to sores in the rectal lining,
itching and bleeding. There may be a blood or mucous discharge or fecal
leakage. Diagnosis includes a rectal exam and medical history.
People with internal intussusception may have difficult bowel movements as
well as a sensation of an incomplete emptying due to the telescoping of the
rectum. Internal intussusception is more common in children than adults.
When it occurs in adults, it is generally due to another intestinal
condition.
Some mucosal prolapses due to constipation resolve with a change in diet,
but complete prolapses and mucosal prolapses that do not resolve with diet
changes usually require surgical intervention, as do internal
intussusceptions.
Please contact us if
you are experiencing any of the symptoms above for an evaluation.
|
