Rectal prolapse

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Written by Deng Heng
Colorectal Surgery
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Can rectal prolapse cause bleeding during bowel movements?

Patients with rectal prolapse may experience bleeding during bowel movements. The primary symptom of rectal prolapse is a protrusion of a swelling through the anus. Initially, the swelling is small and only protrudes during bowel movements, retracting on its own afterwards. As the condition progresses, due to a lack of contraction strength in the levator ani and anal sphincter muscles, the prolapse occurs more frequently and increases in size, requiring manual repositioning back into the anus after defecation. If not repositioned timely, the prolapsed intestinal tract can become edematous, constricted, or even necrotic, which may result in bloody stools.

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Written by Chen Tian Jing
Colorectal Surgery
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The difference between rectal prolapse and rectal prolapse

The difference between rectal prolapse and rectal procidentia mainly lies in the location and extent of the lesions, as well as the degree of the lesions. Rectal prolapse mainly includes internal rectal mucosal prolapse and external rectal mucosal prolapse, and external rectal mucosal prolapse is mainly referred to as rectal procidentia. Hence, rectal procidentia is a manifestation of rectal prolapse, while rectal prolapse is a generalized term for rectal procidentia. If it is an internal rectal mucosal prolapse, one can choose traditional Chinese medicine retention enema or oral medication for treatment. However, if rectal procidentia is confirmed and recurs, the only treatment method is surgery to excise the prolapsed mucosa. To prevent rectal prolapse or rectal procidentia, it is advised not to engage in excessive physical activities.

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Written by Xu Jun Hui
General Surgery
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The difference between rectal prolapse and rectal prolapse.

Rectal prolapse, also known as rectal prolapse, is characterized by partial prolapse of the rectal mucosa in the early stages and full-length prolapse of the rectum in the later stages. Early rectal prolapse is generally accompanied by a feeling of incomplete bowel movements, urgency followed by a feeling of incomplete relief, and perianal contact, with secretions leading to perianal eczema, itching, and infection in the later stages. If the prolapse cannot be reduced, entrapment can occur, causing pain. The initial treatment for rectal prolapse is to ensure smooth bowel movements and reduce factors that increase abdominal pressure to avoid causing the rectal mucosa to protrude outward. Severe rectal prolapse may require surgical treatment.

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Written by Deng Heng
Colorectal Surgery
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Can people with rectal prolapse eat beef?

Rectal prolapse mainly occurs when the rectal mucosa prolapses out of the anus during defecation. If the symptoms are severe, the rectal mucosa can also protrude out of the anus during prolonged standing or exertion. As for whether beef can be eaten, because beef is generally spicy and many cooking methods are spicy, spicy foods can affect bowel movements, causing congestion and swelling of the anal mucosa. Therefore, it is best to avoid spicy beef. Furthermore, beef tends to cause "internal heat" in the body, which can lead to constipation. It is recommended that patients with rectal prolapse eat more vegetables and fruits to maintain smooth bowel movements. Thus, if one really wants to eat beef, it's best to either not make it spicy or to eat it in moderation.

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Written by Chen Tian Jing
Colorectal Surgery
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Can you have children with rectal prolapse?

If a patient is diagnosed with rectal prolapse, they can still have children. However, childbirth can potentially worsen rectal prolapse, especially during natural delivery, where excessive straining in the pelvic and anal areas can exacerbate the condition. Therefore, if a patient already has rectal prolapse, it is advised to consider surgical removal treatment before pregnancy. If rectal prolapse occurs during pregnancy, external wash medications and hot compresses can be used to promote retraction. If rectal prolapse occurs during delivery, surgical treatment can also be carried out after childbirth. However, it is recommended that patients with severe rectal prolapse undergo cesarean delivery to avoid the excessive strain during natural childbirth, which could worsen the prolapse.

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Written by Chen Tian Jing
Colorectal Surgery
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Rectal prolapse treatment

Rectal prolapse is primarily categorized into mild rectal prolapse as well as moderate and severe rectal prolapse. Mild rectal prolapse generally occurs in the early stages of the illness or in children and can be treated conservatively. Conservative treatment mainly involves Chinese herbal retention enemas. On the other hand, moderate and severe rectal prolapse can result in the protrusion of the local mucosa outside the anus, presenting as cylindrical or cone-shaped prolapses. Treating moderate to severe hemorrhoidal prolapse requires surgical intervention. The main surgical methods include hemorrhoidal mucosectomy with stapling and local submucosal sclerosant injections. It is also important to caution postoperative patients against squatting for long periods or straining during constipation, as these actions can exacerbate symptoms of submucosal prolapse.

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Written by Chen Tian Jing
Colorectal Surgery
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Will rectal prolapse cause the stool to become thinner?

Patients with rectal prolapse may experience a narrowing of their stool, which is primarily due to the relaxation of the rectal mucosa associated with rectal prolapse. The relaxed mucosa accumulates at the anus, blocking the passage of feces and thus altering the shape of the stool as it is expelled, generally resulting in thinner or flattened stools. Therefore, if it is definitively diagnosed that the change in stool shape is due to rectal prolapse, surgical treatment is recommended. The surgery involves excising or suturing the excessively relaxed rectal mucosa to allow for a smoother passage of stool and to prevent alterations in stool shape. Additionally, it is important for patients to maintain good lifestyle and bowel habits post-surgery, spend minimal time defecating, and avoid prolonged squatting or straining actions.

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Written by Chen Tian Jing
Colorectal Surgery
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What is the pathogenic mechanism of rectal prolapse?

The pathogenic mechanism of rectal prolapse primarily refers to the relaxation and sagging of the rectal mucosa down to the anal area, forming an internal rectal mucosa prolapse. Excessive relaxation of the rectal mucosa can protrude externally through the anus in a cylindrical or conical shape, commonly known as external rectal mucosa prolapse or rectal prolapse. The causes are mainly due to congenital deficiency of kidney energy in patients or excessive relaxation of the rectal mucosa due to multiple childbirths. Some patients with long-term constipation may also experience rectal mucosal relaxation due to excessive straining during bowel movements. Additionally, elderly and frail patients may experience sagging of the rectal mucosa as they age.

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Written by Chen Tian Jing
Colorectal Surgery
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Can you get pregnant with rectal prolapse?

Patients with rectal prolapse can become pregnant, but if diagnosed with rectal prolapse before pregnancy, it is advisable to first surgically remove the prolapsed mucosa. This is because during pregnancy, as the fetus grows, the pressure in the abdominal cavity gradually increases. Female patients may experience worsening of the rectal prolapse due to increased abdominal pressure, which could lead to increased congestion and edema, thereby exacerbating the severity of existing hemorrhoids or the severity of the rectal prolapse. Therefore, if there are symptoms of rectal prolapse before pregnancy, surgical treatment is recommended. If rectal prolapse occurs during pregnancy, conservative treatment with traditional Chinese medicine enemas can be chosen, and surgery can be considered after childbirth.

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Written by Chen Tian Jing
Colorectal Surgery
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Causes of rectal prolapse

The causes of rectal prolapse primarily include older age or physical weakness leading to relaxation and sagging of the pelvic and rectal mucosa. Prolonged constipation can also lead to excessive straining during bowel movements, causing stress-induced sagging of the intestinal mucosa. Additionally, women who have gone through childbirth may experience rectal prolapse due to excessive straining of the pelvic floor muscles during delivery or increased abdominal pressure during pregnancy, which compresses the rectal mucosa. The treatment for rectal prolapse mainly consists of conservative medication or surgical removal. For mild cases of rectal prolapse, including those in children, traditional Chinese medicine enemas can be used. However, for moderate to severe cases, or cases where prolapse recurs frequently and significantly forms a complete prolapse, surgical removal is recommended.