Can glycerin suppositories be used for rectal prolapse?

Written by Chen Tian Jing
Colorectal Surgery
Updated on September 05, 2024
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If a patient experiences difficulty in defecation or constipation due to rectal prolapse, enemas can be used to help facilitate bowel movements. The basic principle behind the defecation difficulties caused by rectal prolapse is due to the prolapsed, lax mucosa blocking the anal opening, preventing normal excretion of stool. Alternatively, when excretion does occur, it may be impeded by the mucosal obstruction, obstructing the normal passage of feces. Therefore, besides using enemas to address difficulty in defection and bowel movement, it is more necessary to surgically remove the lax mucosa to achieve a fundamental treatment. The use of enemas alone can only provide temporary relief of symptoms and does not address the root cause of the problem. For rectal mucosal prolapse, a stapled hemorrhoidopexy can be performed to surgically remove the prolapsed mucosa.

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Written by Deng Heng
Colorectal Surgery
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The difference between rectal prolapse and rectal prolapse

The term "rectal prolapse" used in folk vernacular covers a wide range, such as incarcerated hemorrhoids, inflammatory external hemorrhoids, thrombosed external hemorrhoids, rectal polyps, and rectal prolapse itself are all referred to as rectal prolapse. Of course, this also includes cases where, due to a lack of medical knowledge, any tumors or flesh-like growth protruding from inside to outside the anus are collectively termed as rectal prolapse. It is evident that the folk term “rectal prolapse” includes conditions like prolapsed rectum, prolapsed internal hemorrhoids, or prolapsed polyps, while the modern medical definition of rectal prolapse specifically refers to the protrusion of the rectum and its mucous membrane; the two should not be confused.

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Written by Chen Tian Jing
Colorectal Surgery
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How is rectal prolapse graded?

Rectal prolapse is generally graded into three degrees: first degree rectal prolapse, second degree rectal prolapse, and third degree rectal prolapse. First degree rectal prolapse is a relatively minor condition where the rectal mucosa protrudes but can retract back on its own. Second degree rectal prolapse is a moderate condition where the protruding mucosa extends approximately 5-10 centimeters, generally forming a conical shape, and requires the patient to manually reposition it. Third degree rectal prolapse indicates a severe condition, with the prolapsed mucosa typically extending beyond 10 centimeters. It may protrude with each incident and could also occur when the patient strains the abdomen or squats. The treatment of second and third degree rectal prolapse generally requires surgical intervention.

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Written by Chen Tian Jing
Colorectal Surgery
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Can rectal prolapse cause stool deformity?

Rectal prolapse primarily refers to the excessive relaxation of the rectal mucosa. It may manifest as relaxation of the rectal mucosa due to the prolapse, and may also result in rectal prolapse. Patients with rectal prolapse may experience deformed stools, mainly because the prolapse overly crowds the anal opening, preventing feces from being normally expelled from the body. When feces are expelled through the anus, the local mucosal compression can cause the stools to appear in thin strips or in a flattened shape. Patients with rectal mucosal prolapse are advised to undergo examinations as soon as possible and actively receive treatment. Options include traditional Chinese medicine retention enemas, combined with oral qi-boosting medications. If the prolapse recurs, or has resulted in rectal prolapse, surgical treatment is recommended.

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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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What tests should be done for rectal prolapse?

Rectal prolapse primarily refers to excessive laxity of the rectal mucosa within the anal canal. This lax mucosa accumulates at the anal opening, forming a clinical symptom. Patients may experience significant local swelling and a feeling of falling down. In severe cases or when the prolapse overly obstructs the anal opening, it might lead to difficulties in defecation and constipation. To diagnose rectal prolapse, an initial assessment typically involves a digital rectal examination and an anoscopy to simply and initially screen for the presence of mucosal prolapse. Further, a defecography might be required to ascertain the severity of the rectal prolapse. For mild rectal prolapse, topical medications can be used to alleviate symptoms. In cases of moderate or severe rectal prolapse, surgery is necessary to excise the lax mucosal loop.