Which department to consult for rectal prolapse?

Written by Chen Tian Jing
Colorectal Surgery
Updated on September 19, 2024
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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.

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Colorectal Surgery
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Clinical manifestations of rectal prolapse

The main symptom of rectal prolapse is a swelling that protrudes from the anus. In the early stages, the swelling is small and only protrudes during defecation, retracting on its own afterwards. As the condition progresses, the protrusion occurs more frequently and grows larger, requiring manual assistance to push it back into the anus after defecation. This is accompanied by a feeling of incomplete bowel evacuation and a feeling of heaviness. If not addressed promptly, the prolapsed intestine may become swollen, constricted, incarcerated, and even risk necrosis. As the prolapse worsens, it can cause varying degrees of anal incontinence, accompanied by the discharge of mucus, which leads to eczema and itching around the anal area.

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Written by Chen Tian Jing
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.

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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.

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Colorectal Surgery
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Can people with rectal prolapse eat beef?

Patients with rectal prolapse can eat beef, but it is not recommended to consume it in excess, as eating too much beef may lead to dry stools or a high fiber content in the feces, making it difficult to expel and potentially worsening the severity of the rectal prolapse. The diet for patients with rectal prolapse should mainly be light, including liquid or easily digestible foods, and avoid spicy foods like chili peppers and seafood or foods with a hard texture. In addition to dietary considerations, patients with rectal prolapse also need treatment to relieve symptoms or cure the condition. Options include traditional Chinese medicine enemas that preserve the function or oral medications that supplement and boost vital energy, as well as surgery to remove the prolapsed rectal mucosa.

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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.