Dealing with rectal prolapse can be tough, but help is available. This issue makes the rectum bulge from the anus, leading to discomfort and other problems. Luckily, there are effective treatments to ease your suffering and control the condition.

Table of Contents

This guide dives into various treatment methods for rectal prolapse. We’ll look at lifestyle changes, medicines, and the newest surgeries. You’ll get the details you need, whether you prefer non-surgical or surgical options, to manage your rectal prolapse.

We’ll start from the diagnostic evaluation and move through the surgical procedures. You’ll discover the possible causes, key symptoms, and the most advanced treatment choices. If you’re facing this issue, keep reading to explore the wide-ranging solutions available.

Understanding Rectal Prolapse

Rectal prolapse happens when the rectum moves out of the anus. It is disturbing and painful. It’s important to know what it is, its causes, and its symptoms to get the right treatment.

What is Rectal Prolapse?

Rectal prolapse occurs when the rectum pushes out. This can be partial or full, with the rectum coming completely out. It usually happens to older adults, women, and those who often strain when using the bathroom.

Causes and Risk Factors

Rectal prolapse is mainly caused by weak pelvic muscles, constipation, and belly pressure. Being pregnant, overweight, or having a chronic cough can make it worse. So can some nerve diseases that affect how your bowels work.

Symptoms and Complications

People with a rectal prolapse might feel full or have trouble using the bathroom. They could also leak stool or see blood and feel sore. Serious issues may include infections, the rectum getting trapped, and not being able to control their bowel movements.

Diagnostic Evaluation

The first step in managing rectal prolapse well is to get an accurate diagnosis. Your healthcare provider might use different tests to see how bad it is and to plan the right treatment.

Digital Rectal Exam

In a digital rectal exam, the doctor checks the strength of your anal sphincter muscles. They do this by gently inserting a lubricated finger into your rectum. They look for any issues that might be connected to rectal prolapse.

Anal Manometry

Anal manometry measures how well your anal sphincter muscles work. It can help find out what’s causing your prolapse. This helps the doctor pick the best treatment for you.

Colonoscopy

To rule out other diseases like colon cancer, a colonoscopy is important. Your doctor will look inside your rectum and colon with a flexible, lighted tube. This helps ensure your diagnosis is correct.

Defecography

Defecography is a test that shows how your lower digestive system works during a bowel movement. It uses X-rays or MRI. It gives a clear picture of your rectal prolapse and any issues with your pelvic floor.

rectal prolapse diagnosis

Non-Surgical Treatment Options

Non-surgical ways can treat mild rectal prolapse. Overcoming straining during bowel movements and eating more fiber are key. Losing weight also helps.
Stool softeners and laxatives make passing stools easier. Biofeedback teaches you to strengthen your pelvic muscles. This can stop rectal prolapse in some cases.

Lifestyle Modifications

Changing your habits can manage rectal prolapse. Avoid straining, boost fiber intake, and keep a healthy weight.
These steps can reduce rectal prolapse symptoms without surgery. So, try these methods first.

Stool Softeners and Laxatives

It’s crucial to keep your stools soft for rectal prolapse management. Doctors might suggest using stool softeners or laxatives. These can cut down on straining. This helps you have normal, pain-free bowel movements easily.

Biofeedback Therapy

Biofeedback is a helpful non-surgical treatment for rectal prolapse. This method uses devices to strengthen your pelvic muscles. Focused exercises enhance muscle coordination. By doing this, your body can better prevent rectal prolapse.

Surgical Procedures for Rectal Prolapse

When rectal prolapse is severe or if non-surgical treatments don’t work, your doctor might suggest surgery. There are two types of surgeries for rectal prolapse: perineal and abdominal.

Perineal Approaches

Perineal procedures enter through the perineum, the space between the anus and genitals. They aim to remove the prolapsed rectal lining. They also tighten the anal sphincter muscle to stop it from protruding again.

Delorme’s Procedure

The Delorme’s procedure is a common perineal surgery. It involves cutting out the prolapsed rectal lining. Then, the surgeon folds in the remaining rectal wall to fix the anal sphincter. This puts the rectum back where it belongs and keeps it from prolapsing again.

Abdominal Approaches

Abdominal surgeries for rectal prolapse are done through a cut in the abdomen. They try to move the rectum back into place inside the pelvis. They also work to make the pelvic floor stronger to prevent its prolapse again.

These surgeries may include rectopexy, which connects the rectum to the sacrum. There are also resection procedures, that remove the prolapsed part of the rectum and colon. Surgeons might use a mesh to reinforce the pelvic floor against prolapse.

The right surgery depends on your age, health, and how bad the rectal prolapse is. Your doctor will help you figure out which surgery is best for you.

 

Perineal Procedures

For those with rectal prolapse, perineal surgeries provide other options. These are for older or weaker patients who can’t handle bigger stomach surgeries. Two common perineal surgeries are the Altemeier procedure and perineal rectosigmoidectomy.

Altemeier Procedure

The Altemeier procedure, or perineal rectosigmoidectomy, involves cutting the dropped rectal tissue and fixing the rest to the anus. It gets rid of the sticking out part of the rectum. A study found this surgery to be safe and work well. It also had a low recurrence rate in a group of 60 patients over time.

Perineal Rectosigmoidectomy

Perineal rectosigmoidectomy is surgery through a cut between the anus and genitals. It removes the slipped part of the rectum and sigmoid colon. This option is picked for older or very sick patients who can’t have big surgeries. Studies show it helps with rectal prolapse. They also found it has good outcomes and low rates of the problem coming back.

The Altemeier procedure and perineal rectosigmoidectomy are important choices to treat rectal prolapse, especially for older or sick people. These methods are less invasive than big belly surgeries. But they might have a higher chance of the issue happening again. It’s key for patients to be carefully picked and checked by a skilled surgeon to choose the best treatment.

rectal prolapse treatment

Delorme’s Procedure

The Delorme’s procedure is a surgery to fix rectal prolapse. It is done through the bottom area. Surgeons take out the part of the rectum that’s sagging and strengthen the muscle around the anus. This makes it less harmful than some belly surgeries. It works well for people who can’t have bigger surgeries.

Complications and Recovery

Any surgery has risks, and so does the Delorme’s procedure. There might be bleeding, getting sick, or the problem coming back. But, getting better usually takes just a few weeks. During this time, people start doing normal things again, including how their bowel works. Talking a lot with doctors helps manage problems and get better.

 

Abdominal Procedures

For severe rectal prolapse cases, doctors may suggest abdominal surgery. These surgeries aim to reposition and secure the rectum in the pelvis. The goal is to offer a more long-lasting fix and lower the chance of the issue happening again.

Rectopexy

Rectopexy is a common surgical procedure. It involves attaching the rectum to the sacrum, a bone at the bottom of the spine. By doing this, the rectum is repositioned and kept in place, preventing it from protruding through the anus. This procedure can be done through open surgery or laparoscopically. The latter has benefits like less trauma and quicker recovery.

Resection Techniques

When rectal prolapse is treated with resection methods, part of the rectum and colon is removed. This typically includes an abdominal incision. Often, this is done together with rectopexy. These procedures aim to fix the root anatomical causes of rectal prolapse.

Mesh Repair

In certain cases, surgeons might use mesh to strengthen the pelvic floor and lower the risk of rectal prolapse coming back. Mesh repair can be combined with rectopexy or resection. This additional support can make the treatment more effective. However, the use of mesh is still an area of active research.

Abdominal surgeries for rectal prolapse take longer to recover from than perineal ones. But, these surgeries might be better at preventing the condition from happening again. Your doctor will think about your health and how severe your condition is. They will choose the best surgery for your specific case.

Postoperative Care and Follow-Up

After rectal prolapse surgery, taking care of yourself is super important. Your medical team will help you get through the recovery. They aim to make sure your body heals well and trouble-free.

Pain Management

Feeling better is key after the surgery. Your doctor might give you pain meds to take. It’s important to use them as told and let your doctor know if you’re still in pain.

Bowel Function Recovery

Getting your bowels back to normal is crucial. You’ll likely have a special diet and need to stick to a schedule. Your doctor will tell you what to eat and if you need any extra meds to help.

Lifestyle Modifications

Changing some habits can keep rectal prolapse from coming back. This might mean eating more fiber, not pushing too hard when you go to the bathroom, and keeping a fit weight. Your healthcare team will fine-tune these tips for you.

 

Recurrent Rectal Prolapse

Rectal prolapse surgery is an effective treatment. But, some patients see the prolapse return. This situation is both frustrating and hard to deal with. It’s important to know the risk factors and available treatments to handle it well.

Risk Factors and Prevention

Older age, ongoing constipation, and certain health issues can up your recurrent prolapse risk. To avoid it, focus on good bowel habits. This means eating more fiber, drinking plenty of water, and not pushing too hard when you go. Your doctor might suggest some changes to your daily routine to lower the risk of recurrence too.

Treatment Options

If your prolapse comes back, your doctor might advise more surgery. This could involve bigger operations through the abdomen or repeating procedures through the perineum. The best course of action depends on your health, age, and how bad the prolapse is.

Working closely with your healthcare team is crucial in managing recurrent rectal prolapse. By following their advice and taking an active role in your healthcare, you can reduce the impact of this condition on your day-to-day and improve your overall quality of life.

Complications and Risks

Rectal prolapse surgery is an effective way to treat the condition. But, it’s vital to know about the risks involved. Like any surgery, it can lead to problems like bleeding, infection, and harm to surrounding parts.

Surgical Complications

Bleeding, bowel blockage, and infection are common issues after surgery. Sometimes, a fistula can form, creating an abnormal link from the rectum to other organs. These problems mean a longer healing time and might need extra steps to fix.

Long-Term Risks

Even after a successful surgery, rectal prolapse might come back. This happens to about 2% to 5% of patients. There’s a slightly higher risk for those who had surgery through the perineum instead of the abdomen. Long-term risks also include incontinence, ongoing pain, and sexual issues.

Before making a decision, talk to your healthcare provider about the surgery. Make sure to ask about the potential rectal prolapse surgery complications and the long-term risks of rectal prolapse surgery. They will help you understand the pros and cons of different treatments. This will help you choose what’s best for you based on your needs and health.

 

Minimally Invasive Techniques

In the last few years, medical progress has made surgery less invasive. This is especially true for fixing rectal prolapse. Laparoscopic and robotic-assisted procedures are now used. They mean smaller cuts, special tools, and less pain after surgery. Patients go home from the hospital sooner and get well faster. These ways of operating are great for old people or those with lots of health problems.

Laparoscopic and Robotic Surgery

This special surgery with small cuts and a small camera has become very popular. It’s called minimally invasive rectal prolapse surgery. Doctors can see everything very well and handle the tissues very carefully. Robot-assisted surgery is also well-liked. A skilled doctor guides a robotic arm to do the surgery in hard-to-reach places with great skill.

Doctors often choose laparoscopic and robotic rectal prolapse surgery because they are better for the patient. After the operation, people have less pain, can leave the hospital sooner, and heal quicker. These methods work especially well for people who can’t have big surgeries, like older patients or those with many health issues.

Special Considerations

Rectal prolapse can happen to anyone. But, it’s important to focus on its impact on children and the elderly. For these groups, unique challenges need special attention. Knowing how to treat rectal prolapse in kids and older adults is key to good care.

Rectal Prolapse in Children

Kids’ rectal prolapse is different from adults. It usually happens because of birth defects, nerve issues, or long-term constipation. Their treatment focuses on fixing the main problem, like easing constipation or dealing with nerve conditions. This helps treat the prolapse directly.

Link to learn more on Pediatric rectal prolapse treatment.

Rectal Prolapse in the Elderly

The elderly, especially those with many health problems, have special issues with rectal prolapse. They might not be able to have surgery due to their health. So, doctors look at other options like biofeedback or smaller operations. These choices help lessen stress on the patient and lower risks.

rectal prolapse in elderly

Quality of Life and Support

Rectal prolapse can make daily life hard, causing both physical and emotional pain. To get better, seek help from doctors and do what they say. Also, talking to people who understand in support groups can make a big difference.

This condition can turn your world upside down, making you feel embarrassed and upset. Getting the right medical help and sticking to your treatment plan are key. They will help you manage rectal prolapse and feel better overall.

Support groups and counseling are hidden treasures for those with rectal prolapse. They offer friendship, advice, and a listening ear. Such connections can really change your outlook on life, helping you live better despite the condition.

Remember, many people face rectal prolapse, so you’re not alone. Tackling your symptoms and feelings head-on can greatly improve your life. There are many resources and people ready to help, so don’t be afraid to look for them.

Conclusion

Rectal prolapse can be treated well using both non-surgical and surgical treatments. Doctors look at what causes it, the symptoms, and how to test for it. Then, they make a treatment plan just for you. This could include changing how you live, taking medicine, or having surgery. The main aim of treating rectal prolapse is to ease symptoms, get your bowels working better, and lift your quality of life.

Research has found different results for surgeries for rectal prolapse. Success rates for long-term surgeries are between 63% and 73%, according to Madiba et al. in 2005. Yet, surgeries for rectal procidentia have even higher success, at 1225-1230%, as noticed by Frykman and Goldberg in 1969. Newer methods like laparoscopic rectopexy have shown good results at first, usually between 41% and 54%, as found by Stevenson and others in 1998.

Staying up-to-date on rectal prolapse management helps you and your doctor choose the best treatment plan. With both simple and surgical treatments, you can get your bowel function under control again. This way, you can make your life better.

FAQ

What is rectal prolapse?

Rectal prolapse happens when the rectum sticks out of the anus. This can lead to discomfort and other issues. Both men and women can get it. It’s often linked to age or problems with constipation.

What are the causes and risk factors of rectal prolapse?

Older adults and those with chronic constipation are more at risk. It happens more in women, too. Weak pelvic muscles and tissues can also play a part.

What are the symptoms of rectal prolapse?

One may feel a fullness in the rectum. Bowel movements can become hard. There might also be incontinence or bleeding from the rectum.

How is rectal prolapse diagnosed?

To diagnose it, a doctor may do a few tests. This can include a digital rectal exam or a colonoscopy. They help rule out other issues.

What are the non-surgical treatment options for rectal prolapse?

For mild cases, changing some habits can help. Try not to strain and eat more fiber. Losing weight if needed is also good. Sometimes, doctors suggest using stool softeners or doing biofeedback therapy.

What are the surgical procedures for treating rectal prolapse?

A few surgeries can fix rectal prolapse. Some are done through the abdomen. Others are more direct, through the perineum. Your surgeon will choose the best type for you.

What is the Delorme’s procedure for rectal prolapse?

The Delorme’s procedure removes the part of the rectum that’s prolapsed. It strengthens the muscles around the anus. This can fix the problem without a big operation.

What are the common abdominal surgical procedures for rectal prolapse?

Abdominal surgeries often involve attaching the rectum to the spine. This is called a rectopexy. Sometimes, doctors remove the prolapsed part of the rectum. Others use a mesh to reinforce the area.

What is the importance of proper postoperative care and follow-up after rectal prolapse surgery?

After the surgery, taking care of yourself is crucial. This includes managing pain and following a special diet. Lifestyle changes are important too. They all help make sure the problem doesn’t come back.

What are the risks and complications associated with rectal prolapse surgery?

Surgery can have risks like bleeding and infections. There’s a chance that incontinence or the prolapse might reoccur. Chronic pain is another possible long-term problem.

What are the special considerations for rectal prolapse in children and the elderly?

Kids with rectal prolapse might need different treatments than adults. For older people, surgeries are usually less intense. The goal is to make the treatment easier to handle.

How can rectal prolapse impact a person’s quality of life, and what support is available?

Rectal prolapse can hurt someone physically and emotionally. It can change daily life in big ways. Getting the right medical treatment and support from others can make it easier to cope.

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