Gives a lot of inconvenience and rather unpleasant disease, which can occur in adults and children is a rectal prolapse, or rectal prolapse. The output part of the rectum or stepping outside of the anus can lead to pain, leaking of bowel contents, bleeding and other debilitating symptoms.
What is rectal prolapse
Rectal prolapse, or rectal prolapse is a pathology in which there is segmental or complete release of the distal part of the intestine outside the anus. According to the international classification ICD 10 code of the disease – K62.3. Segment length can reach from 1 to 20 centimeters. The disease is characterized by the development of the mobility of the rectum, causing it to sprain, muscle weakness and further loss.
The disease is not life threatening. Mucosa, located in the lower part of the large intestine out through the anus outside. This process provokes the compression of the vessels in the submucosal layer. The division, which fell, undergoes degradation, it swells, turns red or blue, growing in size. Timely begun treatment and a reduction of the drop-down area blood circulation is restored, and the mucosa becomes original appearance. The lack of treatment may lead to necrosis of the mucosa.
Causes of rectal prolapse
Rectal prolapse doctors refer to polyetiological diseases. That means prolapse of the rectum is caused by combination of several factors. The disease can occur in adults and children. Etiology, predisposing causes, which significantly increase the risk of pathological conditions, are such violations:
- anatomical defects of the structure of the pelvic bones and intestines (the vertical location of the coccyx, and great depth of the parietal peritoneum, a significant recto-uterine recess, the diastasis of muscle levatores, etc.);
- diseases of the gastrointestinal tract and the genitourinary system;
- neurological problems affecting the spinal cord;
- frequent practice of non-conventional sex;
- decreased muscle tone of the sphincter;
- functional pathology of the pelvis;
- the hereditary factor.
Rectal prolapse in children
For the most part rectal prolapse occurs in children aged one to 4 years. Sometimes there is a gradual loss, in other cases an acute one-time omission of significant plot. The cause of hair loss intestine, the child is not alone. In addition to predisposing factors (congenital anomalies, malnutrition) are producing causes that lead to loss of the intestinal area from the anus to the outside:
- violations of the chair;
- increased intra-abdominal pressure due to prolonged coughing, voiding in boys with phimosis for other reasons.
The main trigger of the disease – difficulties with bowel movements, regular constipation. Long stay on the potty and prolonged straining is bad for the condition of the sphincter. Pediatricians, including Dr. Komorowski, it is recommended to strictly follow the chair of the baby, not to self-medicate for constipation and diarrhea, to seek medical care whenever you need it.
Prolapse of the rectum in women
When the woman is less than normal muscle tone of the pelvic floor can occur rectal prolapse each layer of the plot. Often it occurs after menopause, during which the decreased production of estrogen. These hormones are responsible for elasticity of tissue: mucosa, muscle. There are other causes of rectal prolapse in women:
- Trigger the prolapse can obstructed labor, prolapse of the uterus or vagina.
- During pregnancy the disease occurs due to problems with digestion and bowel movement.
- Frequent constipation cause prolapse of the intestinal segments.
Rectal prolapse in men
Rectal prolapse occurs in men more often than women. Causes of rectal prolapse in men are often associated with heavy physical labor. To pathology can occur for other reasons or their combination:
- frequent significant natureline during bowel movements (e.g. constipation);
- injuries, transactions, previously transferred;
- tumors in this area, polyps, hemorrhoids.
The symptoms of prolapse of the rectum
The clinical picture of acute and chronic forms of the disease are different. In any case the appearance of disease – protrusion of the red (sometimes blue) color. When acute course of the plot falls at one point after heavy lifting or heavy straining. In this case, the patient experiences:
- sharp pain in the anus;
- discomfort in the perineum;
- pain in the muscles of the abdominal wall in front.
Chronic prolapse occurs slowly, it is accompanied by such signs of loss of bowel
- pain in the abdomen;
- bleeding drop-down portion;
- the appearance of the intestinal segment beyond the anus;
- violation of urination.
The stage of rectal prolapse
Doctors klassificeret rectal prolapse in extent, which reflect the stage of the disease. Prolapsed rectums are divided into 4 stages:
- During bowel movements there is a slight eversion of the mucous membrane. The anus remains unchanged, and dropping the segments into the original position on their own.
- During bowel movements eversion of the mucosa are more pronounced. The return of the pathological area is on their own, but slowly. Likely bleeding.
- A large area of mucosa can come out during a bowel movement, during exercise, lifting, coughing or sneezing. There are frequent bleeding, leaking of intestinal contents and gases. The sphincter remains relaxed all the time. Drop-down the reduce segment of your fingers. On some sites detect necrotic tissue and erosion.
- The mucosa and the plots of the sigmoid colon can get out without natureline. The disease is accompanied by itching, severe necrosis. The anus at this stage uncovered, and reduce a segment difficult.
Classification of rectal prolapse
In addition to stages of development of a prolapse of the rectum is characterized by the type of the disease. It can be defined by visual means. Correct diagnosis is necessary for adequate treatment of the disease. The following types of rectal prolapse:
- a sliding hernia;
- intestinal invagination.
Herniated section form
The vulnerability of the rectum associated with specific functions and location. In this regard, the place is affected with cracks, ulcers, polyps and other changes. Hernia of the rectum is bulging of the lower part of the extreme segment of the digestive tract. Hernia the type of prolapse is due to a shift of the anterior wall of the colon down, and access it through the sphincter.
Intussusception of the rectum
When the detachment of a segment of the problem area occurs without prolapse outside the anus, it is about the development of intussusception. Disease, a form occurs rarely and requires a thorough diagnosis. Internal intussusception of the rectum due to partial penetration straight or sigmoid colon mucosa inside the anus.
How to distinguish hemorrhoids from prolapse of the rectum
The similarity of the symptoms of rectal prolapse with hemorrhoids at later stages require a mandatory medical examination that helps to diagnose. Treatment of pathologies radically different, so to begin therapy without a thorough diagnosis dangerous. Visually distinguish one disease from another by the appearance of mucosal folds. When prolapse folds are arranged transversely and hemorrhoids – longitudinally.
Diagnosis of rectal prolapse
Recognition of rectal prolapse begins with a visual inspection of the patient. To see the presence of the pathological process is possible only in advanced cases. In the initial form the patient the doctor will suggest Naturita, crouching down. When the colon is unable to get out, the diagnosis is considered confirmed. Prolapse of the rectal mucosa check by palpation on the lookout chair, check the tone and elasticity of muscle tissue the problem areas. To clarify the diagnosis is possible by such research, such as:
- anorectal manometry.
How to treat prolapse of the rectum
Therapy rectal of loss can be conservative and surgical. Conservative treatment of rectal prolapse begins with identifying the causes of disease and finding methods of getting rid of them. These methods are effective at 1 and 2 stages. They are used for the treatment of problems in pregnant women. In severe forms of rectal prolapse patient is prescribed surgery, form of which is determined by the expert.
When the problem was detected early or in a pregnant woman, the doctor will prescribe a course of conservative therapy. Curative measures involve the waiver of significant loadings on the physical and medicinal treatment of constipation (candles, drops, tablets), exercises to strengthen the pelvic muscles. Modern medicine holds that in the absence of contraindications the only effective measure of treatment external hair loss is surgery. When invagination should first pursue conservative treatment.
All surgical techniques used for treatment of rectal prolapsus, can be divided into the following groups:
- ectomy sigmoid colon (resection);
- suturing or tying of the rectum (rectopexy, kolonopatii);
- plastic surgery, which strengthens the muscles of the perineum and of the pelvis;
- constriction of the anus;
- combining several types of surgery.
The most common operations for rectal prolapse are the methods that fix the dropped plots. For example, to strengthen her gut sutured to a longitudinal spinal ligament. Laparoscopic procedures are actively involved in the practice, reducing the period of rehabilitation and reducing the risk of complications. Modern medicine often uses the following operations:
- delarme’s operation – with rectal prolapse and fecal incontinence;
- operation Terenina-Kümmel-Herzen;
- surgery for the narrowing of the passage through Tirso-Payr;
- strengthening of pelvic floor surgery Briceva.
Treatment of prolapse of folk remedies
In folk medicine, there are several methods to help with rectal prolapse at home. Treatment of rectal prolapse folk remedies should begin only after consulting a doctor. Alternative medicine advises what to do when a rectal prolapse to the outside:
- Bath with chamomile. Of 1 tablespoon of the collection 1 Cup boiling water make a decoction. The liquid is poured into a wider container and sit over her on his haunches. The result is a steam bath.
- Lotions of tincture shepherd’s purse. Dried and powdered herb is placed in a bottle with a narrow neck. She needs to take ¼ of the tank. Pour vodka to the brim. The solution should be to insist in a dark place for a few weeks. The strained infusion is used on the affected area using a cotton pad or swab.
- Infusions for ingestion. If you want to relieve the pain and increase the tone of blood vessels, comes to the aid of calamus root. In a teaspoon of plants need a glass of cold water. The liquid needs to steep for 12 hours. Drink this infusion have 2 tablespoons after a meal.
Exercises with a prolapsed rectum
One of the effective measures for the treatment of rectal prolapse is exercises when prolapse of the rectum. Exercises developed in order to make the muscle tone is stronger to reduce the risk of loss segment. To properly perform complex helps detailed instructions and photos. Doctors recommend the following simple and effective movement:
- Tension and relaxation of the muscles of the perineum and sphincter. In any position fix the muscle in tension for 10 seconds then relax it. Repeat 10 or more times.
- The rise of the pelvis. Take supine position, hands arrange along a trunk, legs bend at the knees. Lift and lower your pelvis without the aid of hands, feet and other body parts.
Video: Prolapsed anus in a child