Rectal prolapse treatment

Written by Chen Tian Jing
Colorectal Surgery
Updated on September 30, 2024
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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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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 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 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 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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Which department to consult for rectal prolapse?

Rectal prolapse is generally divided into internal mucosal prolapse and external prolapse. External mucosal prolapse is commonly known as rectal prolapse, which falls under the category of proctological diseases. Therefore, patients who suspect they have rectal prolapse should promptly visit a proctology department for relevant examinations and treatment. The examination and diagnosis of rectal prolapse mainly involve digital rectal examination, anoscopy, and defecography to confirm the diagnosis. Especially for internal mucosal prolapse, which cannot be seen with the naked eye, defecography is necessary for differentiation. In cases of rectal prolapse, one can generally see a ring-like protrusion outside the anus, and in severe cases, there may be conical or cylindrical prolapse. Regardless of whether it is internal mucosal prolapse or rectal prolapse, surgical treatment is necessary.