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Rectal prolapse: causes, symptoms and treatment

Approximately 0.5% of patients with proctological disorders suffer rectal prolapse. This is a negligible number, so the disease is considered very rare.

However, it cannot be ignored: the lack of treatment will contribute to the prolapse of the intestine over the entire length (in an adult - up to 20 cm).

Content

What is it and why is it happening?

Prolapse, what is it?

General view of the problem, photo

Scientists believe that the disease begins with a violation of the patency of the gastrointestinal tract - intestinal invagination. In other words, one gut is embedded in the lumen of another. This phenomenon is characteristic of infants, but is also found in adults.

Yet it is not only for this reason that the disease develops. There are a number of factors that provoke illness and relate to the anatomical features of the body:

  • weak pelvic floor muscles (unable to cope with straining during bowel movements);
  • abnormally large depth of the parietal peritoneum (the area between the uterus and the rectum);
  • too long mesentery (used to attach the hollow organs of the peritoneum to the abdominal wall);
  • elongated sigmoid colon (located in front of the line);
  • weakened anal sphincter;
  • increased pressure inside the abdominal cavity;
  • vertically located sacrum and tailbone (normal - at an angle).

Prolapse of the rectum None of the above factors are given a leading role, which causes not only problems with an indication of the exact cause of the disease, but also the determination of the optimal treatment.

Sometimes women observe a prolapse of the rectum after childbirth. This is explained by the excessive load associated with the very process of the birth of a child into the world.

However, American statistics indicate a six-fold risk of developing the disease in women over 50 years of age. Of course, in such years usually do not have children.

Scientists suggest that violations occur during childbirth in youth, and closer to old age pathology becomes pronounced.

Clinical statistics of the CIS countries indicates susceptibility to the disease of infants and adult men. In infants up to 1 year, the intestinal muscles simply do not have the necessary tone, but mature men suffer from the disease due to high physical exertion.

In addition, cases of rectal prolapse after anal sex have been reported - frequent relaxation of the sphincter does not pass without a trace.

Symptoms of direct kiki falling out, photo

Photos of the initial stage

Photos of the initial stage

Patients who complain of prolapse of the rectum, symptoms describe in different ways. In general, doctors call the signs of the disease as follows:

  • bowel falls as 1 cm or more;
  • anal sphincter relaxed;
  • spontaneous defecation;
  • gas incontinence;
  • constipation;
  • bleeding.

Usually, the rectum falls during bowel movements, but in the advanced stage this process occurs even with a simple vertical position.

Photo of prolapse of the rectum

Photo 2, prolapse of the rectum

Bleeding is caused by the violation of the integrity of blood vessels. Although it happens rarely and is weakly expressed, such a turn of events cannot be ruled out.

What is the difference between hemorrhoids and prolapse of the rectum?

Rectal prolapse - so scientifically called the prolapse of the intestine, ignorant people are sometimes confused with hemorrhoidal nodes. This is not the same thing.

Diseases have a different etiology, although, at first glance, the node in the anus can also resemble the rectum. In addition, sometimes bleeding is confusing.

Distinguishing illnesses is quite simple: the hemorrhoid has longitudinal folds, and the rectum - transverse.

Rectal prolapse stages

Doctors do not just focus attention on the timely treatment of rectal prolapse. The prolapse of the rectum in women, men and children at first may not bother and even go unnoticed.

However, years later, the pathology will have a very noticeable effect on the quality of human life, in particular because of psychological discomfort. So, the classification of the disease is as follows:

1. Stage I:

  • mucosa is twisted only slightly;
  • observed during bowel movements;
  • the anus remains unchanged;
  • the rectum becomes in place independently.

2. Stage II:

  • mucosa is inverted more pronounced;
  • observed during bowel movements;
  • the anus remains unchanged;
  • independent (but slow) return of the rectum;
  • possible bleeding.

3. Stage III:

  • a large portion of the mucous is reversed;
  • occurs as during defecation, and physical exertion, and coughing, and sneezing;
  • incontinence fecal masses and gases;
  • bleeding occurs more often;
  • the sphincter is not compressed, but remains relaxed;
  • necrosis (dying off) and erosion (surface damage) are detected in some areas;
  • the rectum is set only with the fingers.

4. Stage IV:

  • the mucosa is reversed even without straining (including in the standing position);
  • plots of the sigmoid colon also fall out;
  • pronounced necrosis;
  • itching in the anus;
  • the anus is open;
  • straighten the rectum is very difficult.

Diagnostics

Rectal prolapse stages

The primary diagnosis of rectal prolapse is the examination of the patient. In this case, the patient is asked to squat and imitate the act of defecation.

If the rectal mucosa is visually observed, then the doctor will only have to confirm the diagnosis of "rectal prolapse" by instrumental methods:

Дефектография. 1. Detection. X-rays are taken during the simulation of defecation. Allows you to assess the muscle tone and features of the anatomical structure in the pelvic region.

Ректороманоскопия. 2. Rectoromanoscopy. A proctoscope is inserted into the anus with an eyepiece and illuminant. The gut is examined for new growths and, if necessary, a biopsy is performed. The device penetrates only 20-25 cm deep into the intestine.

Колоноскопия. 3. Colonoscopy. A complete examination of the gastrointestinal tract is carried out with the cause of the disease.

Манометрия. 4. Manometry. Assess the anal sphincter tone.

Treatment of rectal prolapse

Treatment of rectal prolapse

ректального пролапса лечат консервативными методами. The first two stages of rectal prolapse are treated with conservative methods.

If the cause was chronic constipation, then take measures to normalize the stool. If, in the course of the diagnosis, the doctors revealed any primary disease, the therapy is first referred to it.

In addition, the patient will have to limit weight lifting, and about anal sex - to forget.

An excellent remedy for prolapse of the rectum - special physical exercises aimed at strengthening the muscles of the pelvic floor. Often prescribed massage, which is performed directly through the anus.

Sclerotic injections have also proven themselves well. The essence of this method lies in the introduction of drugs that cause tissue necrosis. Subsequently, scars are formed at the injection site, which tighten the intestine.

However, such treatment is possible only in children and adults up to 25 years. Clinical studies indicate that necrosis becomes too pronounced at an older age.

заболевания проводится операция при выпадении прямой кишки. In the third and fourth stages of the disease, an operation is performed in case of prolapse of the rectum.

Doctors call the 3 most effective methods of surgical intervention:

  1. Ectomy of the rectum (remove the drop-down area).
  2. Ectomy of the sigmoid colon (shown with deeper disorders).
  3. Stitching of the rectum (fixing the drop-down area with the help of thread or mesh).

Doctors do not call any one method-panacea. It all depends on the clinical picture of the disease, so sometimes they even prescribe combined operations. For example, first perform a resection, and then - filing.

Surgery for prolapse of the rectum, photo 5

Surgery for prolapse of the rectum, photo 5

In any case, after surgery, regular monitoring of the patient by the doctor for 1 year is required, and special attention will have to be paid to dietary nutrition.

Conclusion

Rectal prolapse is a rare and unpleasant disease. But not fatal. Modern medicine successfully cope with the treatment of disease at all stages.

And yet, doctors recommend not to delay treatment in the hospital, because initially the patient can be helped by conservative methods.

ICD 10: Prolapse

The international classification of diseases of pathology is:

Class XI. Diseases of the digestive organs (K00 — K93)

K55-K63: Other Bowel Diseases

K62 - Other diseases of the anus and rectum

  • K62.3 - Prolapse
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