Rectal prolapse. Rectal prolapse: symptoms, causes, treatment. Possible consequences of prolapse

Rectal prolapse, or prolapse of the rectum, is a fairly rare phenomenon that does not pose a direct threat to life, but causes unpleasant and often painful sensations. The pathology can be partial or complete, but in any case requires timely diagnosis and treatment. How to recognize rectal prolapse, and what to do when symptoms of the disease appear?

Normally, the lower part of the rectum is located just above the anus, but when exposed to negative factors, its anatomical position is disrupted, and part of it extends beyond the anus. The length of the prolapsed area can range from 2 to 20 cm, and in some cases, internal (hidden) prolapse occurs, when segments of the intestine remain in the anus and do not come out. Rectal prolapse occurs in both women and men, regardless of age, but most often the fairer sex over 60 years of age, as well as children under 3-4 years of age, suffer from the disease.

Attention: rectal prolapse is often confused with, but there are significant differences between these two pathologies: with prolapse, prolapse of the rectum occurs, and with pathological (hemorrhoidal) tissue.

Causes of rectal prolapse

The causes of rectal prolapse are unknown - scientists suggest that rectal prolapse is caused by a number of unfavorable factors, which include:

• hereditary predisposition;
• frequent and;
• features of the anatomical structure of the body (wide pelvis, abnormal location of the coccyx and sacrum, etc.);
• congenital and acquired pathologies of the rectum and muscles that are responsible for sphincter contractions;
• infectious and inflammatory diseases of the gastrointestinal tract;
• frequent physical activity;
• difficult or prolonged labor;
• diseases of the genitourinary system;
• exhaustion of the body.

Rarely (in 12-13% of cases), the causes of rectal prolapse are surgical operations on the intestines and pelvic organs and addiction to anal sex.

Attention: In childhood, rectal prolapse occurs quite often, which is due to the characteristics of the growing body and muscle weakness. To prevent the development of pathology, parents need to control the child’s defecation process and not allow him to push for too long.

How does rectal prolapse manifest?

Rectal prolapse can occur suddenly or develop gradually over time. The symptoms in both cases are the same, and they are preceded by distension of the rectum, which occurs unnoticed by the patient.

Abruptly, the rectum falls out, usually after physical exertion (heavy lifting, difficult defecation, childbirth), and in some cases after a coughing or sneezing attack. The process is accompanied by severe pain in the anus, perineum and lower abdomen, and sometimes the pain is so severe that the person goes into shock. During an external examination, a prolapsed section of intestine, small or long, can be seen in the area of ​​the rectal opening. It has the shape of a cylinder, ball or cone of a red or bluish hue with a small hole in the center, and when touched it can begin to bleed.

The gradual development of pathology is more common and is characterized by a gradual increase in symptoms. In the first stages, the patient experiences constipation and difficulty in defecating, which worsen over time, and laxatives and enemas do not give the desired effect. Every attempt to go to the toilet is accompanied by prolapse of the intestine, and the area that comes out becomes larger and larger. The presence of a foreign object is felt in the anal area, and mucus and blood may be discharged from the anus.

Depending on the severity of the symptoms of the disease, rectal prolapse is divided into three stages - mild, moderate and severe.

Table 1. Stages of rectal prolapse

Stage of rectal prolapse	Symptoms
Easy (first)	Bowel prolapse occurs when a person cannot go to the toilet normally and has to push, and the bowel moves back into place on its own.
Average (second)	The bowel prolapses during any physical exertion, including lifting heavy objects, sneezing, coughing, or straining slightly during bowel movements. The prolapsed area cannot be reduced on its own - for this you have to perform certain manipulations
Heavy (third)	A section of the intestine comes out during any movement: walking, trying to get out of bed, etc.

In addition to external prolapse, there is an internal form of the disease, which gives similar symptoms with the difference that the intestine does not prolapse outward, but remains in the anus, and a characteristic ulcer, swelling and hyperemia forms on its wall. Due to the similarity of symptoms with hemorrhoids and other diseases, internal rectal prolapse is more difficult to diagnose than external prolapse, and often causes serious complications.

Attention: in the first stages of rectal prolapse, the intestine can be straightened without medical assistance, but as the pathological process develops, such a measure becomes ineffective.

Why is rectal prolapse dangerous?

Rectal prolapse does not directly threaten the patient’s life, but it is painful and causes serious physical and psychological discomfort. In the later stages of the disease, the intestine falls out with any, even minor movements, and the process is accompanied by fecal and urinary incontinence. If you do not correct the prolapsed section of the intestine or do it carelessly, the blood supply to the tissues deteriorates, which leads to the appearance of ulcers and the development of necrosis, and in some cases can lead to obstruction and peritonitis.

Diagnosis of rectal prolapse

Diagnosis of rectal prolapse is carried out by a proctologist or surgeon. At first glance, making a diagnosis of rectal prolapse is not difficult, but even in cases where the prolapsed section of the intestine is visible visually, the patient requires a number of diagnostic measures to distinguish rectal prolapse from hemorrhoids and other neoplasms.

1. External examination and palpation of the affected area. The patient is on an examination chair, and the doctor examines his rectal area, paying attention to the condition of the tissues, the presence or absence of formations, and if the prolapsed area can be examined visually, evaluates its shape, size and color.
2. Endoscopic examination. The technique allows you to identify diverticula (protrusions) on the walls of the mucous membranes, as well as malignant and benign formations.
3. and rectomanoscopy. They make it possible to visualize the intestines from the inside and detect pathologies that led to rectal prolapse.
4. X-ray of the intestines. It is carried out to identify anatomical changes in the large intestine and deterioration of its functional state.
5. Histological examination. The procedure is prescribed for suspected benign and malignant intestinal neoplasms.

If necessary, patients may be prescribed additional studies, including anal manometry, electromyography, study of the transit time of stool through the colon, etc., as well as consultation with an oncologist and gastroenterologist.

Important: internal intestinal prolapse cannot be felt by palpation, so making a diagnosis for this form of the disease is significantly difficult.

How to treat rectal prolapse?

When rectal prolapse occurs, first of all it is necessary to set the prolapsed area, and to do this as quickly as possible - the longer it is outside the anus, the more swelling increases, and subsequently it will be much more difficult to correct the situation. In adults, the procedure is performed in the knee-elbow position or lying on the left side - the intestine should be carefully inserted into the anus to restore blood circulation and the normal appearance of the mucous membrane. After this, patients are prescribed therapy, which is aimed at preventing intestinal prolapse in the future.

Conservative treatment of rectal prolapse is effective only in the first stages of the disease, and medication must be combined with physiotherapeutic procedures and therapeutic exercises. In advanced cases and in the absence of effect from conservative therapy, surgical treatment is indicated for patients.

Conservative therapy

Conservative treatment of anal prolapse should be comprehensive and based on a number of general principles.

1. Identification and treatment of concomitant diseases of the large intestine. Most often, rectal prolapse is accompanied by hemorrhoids and ulcerative lesions of the mucous membranes, which require appropriate therapy.
2. Normalization of nutrition and daily routine. Constipation is one of the main provoking factors in the development of rectal prolapse, so patients need to organize their diet in such a way as to exclude intestinal disorders. It is necessary to exclude fried, salty, pickled and fatty foods, cabbage, brown bread, legumes and other foods that cause increased gas formation from the diet. Food must be boiled or steamed, taken in small portions and preferably at the same time.
3. Symptomatic treatment. To eliminate the symptoms of the disease, antispasmodics, laxatives or antidiarrheals, probiotics and prebiotics are used to improve intestinal microflora. Patients may also be prescribed injections of sclerosing drugs, electric stimulation and rectal massage.
4. Physiotherapy. Special exercises help strengthen the sphincter and pelvic floor muscles, which prevents prolapse of sections of the intestine in the future. Such exercises include tensing the sphincter and perineum muscles, lifting and moving the pelvis from different positions.

In addition, patients with this diagnosis need to adhere to a daily routine, avoid heavy physical activity, walk in the fresh air as often as possible and lead a safe sex life (any stimulation of the anus is prohibited).

Important: Conservative treatment gives the necessary effect only in 2/3 of cases of rectal prolapse - every 3-4th patient requires surgical intervention.

Surgical treatment

Surgical treatment of rectal prolapse, as a rule, gives good sustainable results that last for a long time. The procedure for performing the operation is determined by the doctor depending on the stage of the pathological process, symptoms and general condition of the patient’s body.

Possible surgeries for rectal prolapse include:

• fixation (suturing) of the intestine from the perineum or peritoneum;
• resection or removal of the affected area;
• sphincter and pelvic floor plastic surgery;
• photocoagulation;
• narrowing of the anal opening.

Since rectal prolapse is often combined with other pathologies (muscle weakness, hemorrhoids, etc.), most patients require a combination of several techniques. The operation can be performed traditionally or laparoscopically - the latter is a bloodless and low-traumatic procedure that does not require a long recovery period.

For reference: after surgery, patients improve muscle tone, intestinal and sphincter function, but final conclusions about the effectiveness of treatment can be made only after a year.

Folk remedies

Treatment of rectal prolapse with folk remedies is possible only in combination with conservative therapy, and before using them you should consult a doctor, since incorrectly selected prescriptions can aggravate the patient’s condition.

1. Swamp calamus. Take a teaspoon of dry roots of the plant, chop and pour a glass of cold boiled water. Infuse in a tightly closed container for 12 hours, take 1-2 teaspoons before meals, preheating the infusion.
2. Oak and chestnut. Grind 100 g of oak bark and horse chestnut fruits, pour two tablespoons of the resulting mixture into 2.5 liters of water and boil. Strain the resulting liquid and use it for baths and washing.
3. Chamomile. Place ordinary chamomile herb in a deep basin or bucket, pour boiling water over it, then sit over the emanating steam and sit for 15-20 minutes, covered with a blanket to improve the effect. The procedure should be performed carefully so as not to burn the anus.

   Common cuff

Important: Some folk remedies can cause allergic reactions and other unpleasant symptoms, so they should be used with caution.

A properly selected surgical technique can eliminate rectal prolapse and achieve stable remission in 75% of patients. The risk of developing a recurrence of rectal prolapse ranges from 10 to 50%, depending on the general condition of the person, the clinical course of the disease and the body’s response to therapy.

Prevention of rectal prolapse

Prevention of rectal prolapse consists of proper nutrition with plenty of fiber, timely treatment of hemorrhoids and gastrointestinal diseases, and light physical activity. After reaching the age of fifty, you should undergo preventive examinations with a proctologist once a year, since the likelihood of intestinal pathologies in older people increases significantly.

Rectal prolapse is a serious disease that worsens the patient’s quality of life and may be accompanied by complications, but with timely diagnosis and proper treatment, it can be eliminated without health consequences.

Video - Rectal prolapse

Rectal prolapse (rectal prolapse) is a pathological condition in which the rectum protrudes outward from the anus or becomes displaced and relaxed inside the anus. Bowel prolapse occurs more often in men than in women. When the rectum suddenly comes out of the anus in the form of a tourniquet, this is very frightening for adults, and they do not know what to do, but most try to straighten the rectum on their own, rather than seek help, which is not correct, since such a pathology does not occur without a reason and can lead to complications.

Causes

Intestinal ectropion does not happen just like that; in some cases there are not only factors that contribute to prolapse, but also predisposing factors that increase the risk of intestinal prolapse.

The latter factors include:

• sphincter weakness;
• structural features of the large intestine and rectum;
• vertical position of the coccyx;
• passion for anal sex;
• sprain of the rectum and colon;
• heredity;
• elongated thick, sigmoid part of the intestine;
• pelvic problems.

These factors only increase the risk of rectal prolapse, but do not trigger the development of this pathology.

In an adult and a child, the reasons for the fact that the intestines come out will be the following factors:

In adults	In children
Chronic diseases of the gastrointestinal tract (diverticulitis, sigmoiditis, paraproctitis, proctitis and much more)	Weakness and immaturity of the intestines
severe overexertion (one-time heavy lifting or constant heavy physical work)	sphincter weakness
abdominal trauma	frequent constipation
after childbirth, a woman may have a prolapse of the uterus, which will lead to prolapse of the rectum so much that it comes out of the anus	unbalanced diet
During pregnancy, there is a load on the entire intestine, which causes constipation and, when you push, the rectum falls out	subconscious retention of bowel movements
hernias in the pelvis or spine	earlier potty training a child
ulcers on the intestinal mucosa	respiratory illnesses that result in severe coughing and sneezing may be the cause of bowel prolapse
coccyx injury	haemorrhoids
frequent constipation (pushing causes the rectum to fall out during bowel movements)	Hirschsprung's disease
problems of the genitourinary system (when straining to achieve results, part of the intestine falls out)	immobility of the rectum in the anus

Video

One of the main causes of constipation and diarrhea is use of various medications. To improve bowel function after taking medications, you need to do it every day. drink a simple remedy ...

Stages and forms of development

Prolapsed intestine can have different types, and therefore there are two forms of this pathology:

• hernial- the rectum is exposed to strong intra-abdominal pressure and over time a small protrusion from the anus appears, up to complete prolapse of the intestine;
• intussusception— the rectum did not fall out in this case, but an internal invagination of a segment occurred in the intestine itself near the anus.

The stages of development of this pathology are also distinguished:

1. initial stage characterized by the fact that the prolapse is only partial and is observed after defecation. It looks like a small bump near the anus. Reduction of the intestine occurs on its own almost immediately.
2. Compensated stage passes more difficult. After defecation, the rectum prolapses more and returns more slowly to its normal position. The passage of feces is accompanied by pain and slight bleeding.
3. Subcompensated stage much more difficult for the patient. The intestines fall out during physical activity, cannot be adjusted on their own and help is needed. The bleeding increases and the intestines hurt more.
4. Decompensated stage or the last one. The intestine has come out almost completely, it is difficult to put it back in place. The bleeding is profuse and frequent, the pain practically does not subside. Bowel prolapse occurs all the time, even when sitting or standing.

Video

Symptoms

Symptoms of rectal prolapse will intensify as the disease progresses, the main ones being:

• stomach ache;
• soreness in the anus, which goes away after defecation;
• feeling of excess in the anus;
• bleeding from the rectum;
• frequent urge to defecate (sometimes false);
• bowel disorders (constipation).

Complications

If the pathology is not treated for a long time, then strangulation of the rectum may occur (it can also form when trying to straighten the prolapsed segments on your own).

Intestinal obstruction may also occur, especially if there is internal pathology. In the most severe cases, peritonitis may develop.

Diagnostics

First of all, the doctor will conduct a visual examination and, if the disease is in its final stages, a presumptive diagnosis will be established immediately.

To confirm it, you need to do the following:

• finger diagnostics;
• sigmoidoscopy;
• colonoscopy;
• X-ray of the intestines;
• sphincterometry.

These tests allow not only to diagnose rectal prolapse, but also to differentiate it from hemorrhoids.

How to distinguish hemorrhoids from prolapse?

The first differences between hemorrhoids and rectal prolapse will be noticeable already with a digital examination and visual inspection of the prolapsed area. With hemorrhoids, the folds of the node will have a longitudinal shape, and if they fall out, they will have a transverse shape. This is their only difference, which can be established visually during external examination, and during internal invagination using special devices. It is extremely important to distinguish them, because how to treat the problem will depend on the diagnosis.

Treatment

Treatment for rectal prolapse will vary depending on the stage at which the disease is diagnosed. At first, conservative methods are sufficient, but if the disease progresses for several years, then surgical intervention is necessary.

Also, in the early stages, traditional methods can be effective, which should complement drug therapy and be agreed with a doctor.

Conservative methods

If the disease is diagnosed at the very beginning, then electrical stimulation of the pelvic muscles and the administration of sclerosing drugs can be effective. It is also necessary to perform special exercises to strengthen the muscles of the pelvis and anus. To do this, you need to strain the muscles of the perineum inward and push outward, do them alternately every day. Raising the pelvis from a supine position with your knees bent is also effective.

It is important to normalize your diet so that neither constipation nor diarrhea affect the course of treatment, and the intestines are quickly and easily emptied without straining. It is necessary to reduce physical activity associated with lifting weights.

Video

Surgical intervention

Surgery is sometimes the only way to help a person with rectal prolapse.

The following operations are performed:

• cutting out the affected part of the intestine (a certain segment);
• suturing (the back wall of the vagina and tailbone can hold the rectum, which is sutured to them with special threads and wires);
• intestinal plastic surgery;
• You can tighten the rectum using combined methods.

These operations are performed using laparoscopy, which significantly increases the speed of recovery and reduces the rehabilitation period.

Folk remedies

After consulting with your doctor, you can help yourself using the following methods:

• infusion of shepherd's purse - good for washing the anus;
• chamomile baths - if you sit in them for 15 minutes a day, the intestines are well steamed and local immunity is strengthened;
• infusion of common cuff - drink one glass of infusion of water and a teaspoon of herbs during the day;
• infusion of calamus - take a few sips after meals (a teaspoon of herb is poured into a glass of cold water and infused for a day).

If you seek medical help in time, the pathology can be easily cured using conservative methods. But most patients still need surgery; a positive outcome and complete recovery are noted by 80% of patients. So you shouldn’t be afraid of it and suffer all your life, it’s better to immediately listen to the doctor and forget about the problem once and for all.

Rectal prolapse (rectal prolapse, pelvic floor prolapse)

This is a condition when the rectum or part of it loses its proper position inside the body, becomes mobile, stretches and comes out through the anus. Rectal prolapse is divided into two types: internal (hidden) and external. Internal rectal prolapse differs from external rectal prolapse in that the rectum has already lost its position, but has not yet come out. Rectal prolapse is often accompanied by weakening of the anal canal muscles, which leads to incontinence of gas, feces and mucus.

The problem of rectal prolapse occurs quite often in our patients. This condition is also known as rectal prolapse or pelvic floor prolapse and is more common among women than men.

In women, the main factors for the development of rectal prolapse are pregnancy and childbirth. The prerequisites for the appearance of the disease in men may be regular physical activity or the habit of strong straining.

Rectal prolapse usually does not cause pain at the very beginning of the disease. The main problems with rectal prolapse for patients are a feeling of discomfort and a foreign body in the anus, as well as an unaesthetic appearance, which significantly worsens a person’s quality of life.

Rectal prolapse usually responds well to treatment and has a low recurrence rate (recurrence of the disease) - only about 15%. Complications in treatment usually arise when the patient seeks specialized help late and attempts to self-diagnose and treat. The result of these actions is lost time for success in treatment. If no treatment is taken, part of the prolapsed intestine will gradually increase, in addition, the anal sphincter will stretch, and the likelihood of damage to the pelvic nerves will also increase. All this entails the following complications:

• Ulcers of the rectal mucosa.
• Tissue death (necrosis) of the rectal wall.
• Bleeding.
• Incontinence of gas, mucus and feces.

The length of time over which these changes occur varies widely and differs from person to person; no doctor will give an exact time frame for how long these serious problems can occur.

Normal condition

With loss

Rectal prolapse and hemorrhoids

One of the common reasons why a patient does not see a doctor immediately after a problem arises is the external similarity of the manifestation of the disease with hemorrhoids, which they try to cure on their own - with suppositories and ointments. In fact, rectal prolapse and hemorrhoids are completely different diseases, which may actually appear similar in appearance due to the influx of tissue from the anal canal. Only with hemorrhoids does the hemorrhoidal tissue fall out, and with rectal prolapse does part of the rectum fall out. Also, both diseases have some similar symptoms, such as bleeding.

It is important to remember that incorrect diagnosis and incorrect treatment will never lead to the expected positive effect, and in some cases will worsen the problem.

Rectal prolapse. Causes of the disease.

In most cases, an experienced doctor will be able to make a diagnosis during the initial examination. However, there are additional research methods that can assess the severity of the disease and help in the correct choice of a particular treatment method.

Studies that may be required to determine the severity of rectal prolapse:

• Anal electromyography. This test determines whether nerve damage is causing the anal sphincters to not work properly. It also covers coordination of the rectum and anal muscles.
• Anal manometry. This test examines the strength of the anal sphincter muscles. The study allows you to evaluate the holding function.
• Transrectal ultrasound examination. E This test helps evaluate the shape and structure of the anal sphincter muscles and surrounding tissues.
• Proctography (defecography). This test evaluates how well the rectum holds stool and how well the rectum empties.
• Colonoscopy. Allows you to visually examine the entire colon and helps identify certain problems.

Our Clinic has all the necessary diagnostic services. We also work closely with urologists and gynecologists from other departments of Sechenov University, which allows us to approach the issue of treating rectal prolapse multidisciplinary, that is, jointly.

Rectal prolapse. Treatment.

Our Clinic provides the full range of treatment for rectal prolapse. Based on the stage of the disease and its manifestations, our specialists select the most optimal treatment method. It is important to understand that rectal prolapse is a complex disease that cannot be treated without surgery. To treat rectal prolapse, our Clinic uses the following surgical techniques:

Abdominal surgeries (surgeries through the abdominal cavity)

1. Operation rectosacropexy - a mesh allograft (alloprosthesis) is used for it, which holds the intestine in a given position. During the operation, the rectum is mobilized to the level of the levator ani muscles, then the rectum is pulled up and fixed to the presacral fascia, located between the sacrum and the rectum, using a mesh allograft.

2. Kümmel's operation is the fixation of the previously mobilized rectum to the promontory of the sacrum with interrupted sutures.

These operations can be performed either openly through incisions (laparotomy) or laparoscopically through small punctures.

Transanal operations (operations through the anal canal)

1. Delorme's operation is the removal (resection) of the mucous membrane of a prolapsed section of the intestine with the formation of a muscle cuff that holds the intestine, protecting it from prolapse.

2. Altmeer's operation - resection of the rectum or its prolapsed section with the formation of a coloanal anastomosis - joining the colon to the anal canal.

Surgical treatment in most cases allows patients to completely get rid of the symptoms of rectal prolapse. The success of treatment depends on the type of prolapse - internal or external, on the general condition of the patient and on the degree of neglect of the disease. Patients may need some time to regain gastrointestinal function. After surgery, it is important to control bowel movements, avoid constipation and severe straining.

Most cases of rectal prolapse can be successfully treated, often with surgery.

Classification

There are three types of rectal prolapse:

• Partial prolapse (prolapse of the rectal mucosa) . The rectal mucosa slips from its normal position and usually comes out of the anus. This occurs when a person strains during bowel movements. The most common prolapse of the rectal mucosa is in children under 2 years of age.
• Complete loss . The entire wall of the rectum slides out of its normal position, emerging from the anus. At first this only happens during bowel movements. As the disease progresses, the rectal wall falls out while standing or walking. And in some cases, it may remain outside the anus all the time.
• Internal rectal prolapse . One section of the wall of the colon or rectum may slide in or out of another, like folding parts of a telescope. At the same time, it does not come out through the anus. Internal rectal prolapse is more common in children, but the causes, as a rule, cannot be determined. In adults, it is usually associated with other intestinal diseases such as polyps or tumors.

There are other classifications of rectal prolapse. But they are difficult to understand, so only doctors use them.

Causes

Rectal prolapse in adults can have various causes and risk factors:

In children, the rectum most often prolapses if:

• Cystic fibrosis.
• Previously undergone surgery on the anus.
• Nutrient deficiency.
• Problems with physical development.
• Infectious diseases of the digestive tract.

Symptoms of rectal prolapse

Most people can guess what advanced rectal prolapse looks like. However, it is important to detect this problem early in development.

The first symptoms of rectal prolapse:

• Leakage of feces from the anus - fecal incontinence.
• Leakage of mucus or blood from the anus (constantly wet anus).

As rectal prolapse progresses, the following symptoms appear:

• Feeling of fullness in the intestines and the urge to defecate.
• Frequent bowel movements with a small volume of stool.
• Feeling of incomplete bowel movement.
• Pain, itching, irritation in the anal area.
• Bleeding from the anus.
• The presence of bright red tissue protruded from the anus.

Anyone who experiences these symptoms of rectal prolapse in themselves or their child should consult a doctor.

Diagnostics

To establish a diagnosis, the doctor first asks the patient about his complaints, the presence of other diseases and previous operations, after which he examines the rectum.

To confirm the diagnosis and identify the cause of rectal prolapse, a:

• Anal electromyography. This test can determine whether nerve damage is causing the anal sphincter dysfunction. It also examines the coordination between the rectum and anal sphincters.
• Anal manometry. The test examines the strength of the anal sphincters.
• Ultrasonography. Allows you to evaluate the shape and structure of the anal sphincters and tissues surrounding the rectum.
• Proctography. An X-ray method that allows you to evaluate the functioning of the rectum.
• . Endoscopic examination of the large intestine using a flexible instrument with light (colonoscope) and a video camera.
• Magnetic resonance imaging. Used to examine the pelvic organs.

If a child's rectum prolapses and no cause can be found, he or she may need a sweat test to check for cystic fibrosis.

Treatment

How and with what to treat rectal prolapse depends on many factors, such as the patient’s age, the severity of the disease, and the presence of other problems with the pelvic organs.

It should be noted right away that there are no medications that could cure this disease in adults. All treatment comes down to measures carried out at home and surgery.

At home, for the treatment of partial rectal prolapse, adult patients are recommended:

• Set the prolapsed intestinal wall back if the doctor allows it.
• Avoid constipation. To do this, you should drink plenty of fluids, eat fruits, vegetables and other foods that contain a lot of fiber. These dietary changes are often enough to improve or eliminate rectal prolapse.
• Do special gymnastics. If you have rectal prolapse, you should regularly perform Kegel exercises, which help strengthen the perineal muscles.
• Do not strain when defecating. If you need to make it easier to pass stool, you need to use stool softeners.

Adults with complete rectal prolapse or partial rectal prolapse that does not improve with home treatment tips require surgery.

There are several types of operations, the choice of which is made by the doctor, taking into account the patient’s gender, bowel function, previous surgical interventions, the severity of other diseases, the degree of prolapse, and the risk of complications.

All these operations can be divided into two types, based on the surgical approach:

• Abdominal surgeries (surgical access through the abdominal cavity). As a rule, during these interventions, fixation of the rectum or resection of part of it is performed with subsequent fixation. They are performed in most cases under general anesthesia. Sometimes fixation of the rectum is done laparoscopically - through several small holes in the abdominal wall.
• Rectal (perineal) operations . These surgeries are more often performed in older adults and patients with serious underlying medical conditions. During such operations, an incision is not made in the wall of the abdominal cavity; resection and fixation of the rectum is carried out through the anus.

Features of treatment in children

Parents who see a small protrusion of bright red tissue from their baby's anus should consult a doctor immediately. Only he can explain to them in detail what to do if a child’s rectum prolapses. The good news is that this problem, with proper treatment, can completely disappear without surgery.

The doctor should teach parents how to properly reduce a child's rectal prolapse using a water-soluble lubricant. You should also buy a special potty on which the baby does not strain during bowel movements.

You need to strive to eliminate constipation, which can be achieved through a balanced diet, the use of stool softeners and laxatives. Very rarely, submucosal injections of a sclerosing agent are used to treat rectal prolapse in children.

If these conservative methods are ineffective and complications of rectal prolapse develop, surgical treatment is performed.

Complications of bowel prolapse

Complications of rectal prolapse include:

• Formation of ulcers on the rectal mucosa.
• Necrosis of the rectal wall.

The following complications may also develop during surgical treatment:

• Bleeding.
• Divergence of the edges of the anastomosis is the connection of the two edges of the rectum after resection of its prolapsed part.
• Worsening or appearance of fecal incontinence.
• Worsening or appearance of constipation.
• Recurrence of rectal prolapse.

Forecast

90% of children with rectal prolapse under the age of 3 years only need conservative treatment; their disease resolves. Only 10% of them continue to have this problem into adulthood. For children whose prolapse appears after age 4, spontaneous recovery is much less common.

In adult patients, the prognosis depends on the cause of the disease, age and general health. Unfortunately, even after surgery, relapses occur in 30-40% of patients.

Prevention

You can reduce your risk of developing rectal prolapse by reducing constipation. This is achieved by eating a high fiber diet and drinking enough fluids. You should also avoid straining during bowel movements.

People with long-term diarrhea, chronic constipation, or hemorrhoids need treatment for these conditions to reduce the risk of developing the condition.

Although rectal prolapse is thought to be a rare condition, its incidence may be underestimated, especially in older adults who do not seek medical attention for the problem.

Having this disease can greatly reduce your quality of life. In the later stages of prolapse, there is no effective conservative treatment; surgical interventions are necessary.

Useful video about rectal prolapse