Clinical manifestations of rectal prolapse

Written by Chen Tian Jing
Colorectal Surgery
Updated on September 19, 2024
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The clinical manifestations of rectal prolapse mainly involve the contents within the anal canal, especially the prolapse of the rectal mucosa outside the anus, which is most common. Severe cases of rectal prolapse may lead to a cylindrical or conical prolapse. The common type of rectal prolapse mainly refers to rectal prolapse, but there can also be internal prolapse of the rectal mucosa. Internal prolapse of the rectal mucosa is characterized by excessive relaxation and accumulation of the rectal mucosa at the anus, causing symptoms such as a sense of blockage, downward pressure, and obstruction during bowel movements. This can be definitively diagnosed through an anal examination and defecography. Regardless of whether it is internal prolapse of the rectal mucosa or rectal prolapse, when the disease progresses to a severe degree affecting the patient's normal life, surgical treatment is recommended.

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Written by Deng Heng
Colorectal Surgery
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Why won't rectal prolapse heal?

The causes of rectal prolapse are complex, and they are not fully understood at present. It is considered to be related to multiple factors: The first factor is anatomical, where underdeveloped or malnourished children, or weak elderly individuals are prone to having weak and powerless levator ani muscles and thin pelvic fascia. Other anatomical issues include a less curved or overly straight sacrum in children, surgical trauma, or damage to the muscles and nerves around the anus. The second factor is increased abdominal pressure, such as from constipation, diarrhea, prostate enlargement, chronic cough, or difficulty urinating, all of which can heighten abdominal pressure and exacerbate rectal prolapse. The third factor is diseases around the anus, such as internal hemorrhoids and rectal polyps that frequently protrude, pulling down the rectal mucosa and easily inducing rectal prolapse. Therefore, its causes are complex, and so is its recovery.

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Written by Chen Tian Jing
Colorectal Surgery
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How long does it take to recover from rectal prolapse surgery?

Rectal prolapse, if treated surgically, then postoperative recovery requires about 20 days to a month. Rectal prolapse involves the protrusion of part of the mucosa within the anal canal. Symptoms before surgery are generally severe, and if traditional surgical methods are used, the surgical wound is larger, resulting in a longer recovery time. It is recommended that patients rest in bed post-surgery for at least one week to ten days, avoiding getting out of bed too early or engaging in mental activities prematurely, which could cause the mucosa not to adhere properly and lead to a secondary prolapse. Patients who undergo surgery for rectal prolapse also need to have regular follow-ups, avoid strenuous abdominal activities, and be mindful of potential complications such as dry stool or difficulty defecating, avoiding prolonged squatting during these situations.

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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 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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Colorectal Surgery
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Can rectal prolapse heal itself?

Rectal mucosal prolapse primarily refers to a condition where the rectal mucosa becomes excessively relaxed, accumulates near the anus, and presents symptoms such as a distinct feeling of fullness and downward pressure at the anal area. Sometimes, the prolapsed mucosa may congest the anal opening, causing difficulty in defecation or even constipation. Rectal mucosal prolapse cannot heal completely on its own. Treatment options include medication to alleviate symptoms or surgery to remove the prolapsed mucosa. Patients with rectal mucosal prolapse should avoid straining excessively during bowel movements. If constipation occurs, patients should not strain too hard and may use enemas to assist with bowel movements.