What is the pathogenic mechanism of rectal prolapse?

Written by Chen Tian Jing
Colorectal Surgery
Updated on September 27, 2024
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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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How to treat rectal prolapse?

Rectal prolapse mainly includes external rectal mucosal prolapse and internal rectal mucosal prolapse. External rectal mucosal prolapse primarily refers to the symptoms and types of clinical rectal prolapse. The most common and effective treatment for rectal prolapse or internal rectal mucosal prolapse is surgery. Simple medication can only relieve local relaxation or compressive symptoms, but it does not have a definitive therapeutic effect on the disease itself. The surgery mainly involves the removal and excision of the relaxed and prolapsed mucosa, thereby increasing the tightness of the intestinal mucosa and relieving the local mucosal pressure on the anus, which causes the patient's feelings of bloating and descent. After the surgery, patients need to rest in bed for a week and should avoid squatting and excessive abdominal straining in their future activities.

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Written by Deng Heng
Colorectal Surgery
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Postoperative Care for Rectal Prolapse Surgery

Post-Rectal Prolapse Surgery Precautions: 1. Rest in bed, which helps improve the recovery rate. Due to gravity, many patients with rectal prolapse experience prolapse when standing or walking. Although the surgery fixes the prolapsed mucosa, the firmness of the fixation takes time to establish. Therefore, it is recommended to rest in bed with limited activity for one week after the surgery to solidify the therapeutic effects. 2. Take oral antibiotics for 7 to 10 days after surgery. 3. Abstain from food for the first two days after surgery, and consume semi-liquid or liquid foods in reduced quantities on the third day. 4. Refrain from defecating for 4 to 5 days after surgery. 5. Do not strain during the first bowel movement after surgery. (Please use medications under the guidance of a professional physician)

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Written by Chen Tian Jing
Colorectal Surgery
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Clinical manifestations of rectal prolapse

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 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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How to check for rectal prolapse?

Rectal prolapse is generally divided into internal rectal mucosal prolapse and external prolapse, also known as rectal procidentia. If it is an internal prolapse, an anoscopy combined with defecography is required to examine the degree of laxity of the local rectal mucosa. If it is an external prolapse or rectal procidentia, the patient generally presents with a prolapsed swelling when squatting, and this can be further evaluated with a digital rectal examination to assess the local tightness of the anus. If rectal prolapse occurs, surgical treatment is recommended as it tends to be quite effective. In cases of pediatric prolapse or mild prolapse, traditional Chinese medicine enemas may be used to alleviate local symptoms.