Rectal prolapse: symptoms, causes and treatment

This alteration in the organization of the digestive system can be a major health problem.

The digestive system is one of the most important parts of our organism, since through food we can obtain energy and nutrients from the external environment.The digestive system is one of the most important parts of our body, since through food we can obtain the energy and nutrients from the external environment that we need to keep our body functioning and to survive.

But the digestive system has not only an entry point but also an exit point: the rectum and the anus. These elements, which in addition to the digestive system are part of the excretory system, are essential in order to eliminate the organic waste produced by the functioning of our body and the remains of food that our body is not able to use.

However, sometimes diseases, disorders or alterations may appear that make the excretion of feces complicated or uncomfortable, or even cause a part of our organism to protrude. This is what happens with rectal prolapse, which we will discuss below.of which we are going to speak next.

What is a rectal prolapse?

It is called rectal prolapse to the medical condition in which the rectum protrudes outside the anus, that is to say that it slips outward. This protrusion can be partial or complete, and may even protrude outside the anus. The final part of the intestine loses the natural anchorages that make it remain inside the body, which causes the sliding. The rectum becomes inverted, with the mucous lining of the rectum visible from the outside in the form of a red in the form of a red, finger-like extension.

This problem can be quite uncomfortable for those who suffer from it, as it is common for irritation, Pain or defecatory problems to appear. It can also generate symptoms such as diarrhea or constipation, secretions or even fecal incontinence (losing the ability to control excretion). Also, the prolapsed rectum can become perforated or ulcerated, generating hemorrhages that may even require urgent intervention. This problem can appear at any age and in either sex.. It is especially frequent in children under 6 years of age, being another type of population in which it is highly known in adults over 50 years of age. It tends to be more frequent in women.

It is common for this condition to progressively worsen, with initially only the mucosa protruding and only in situations of anal straining such as defecation, returning to its original place shortly thereafter. Gradually, however, the rectum will be left outside the body more and more often and in more and more situations if it is not treated. In the case of women, it is possible that the protrusion of the rectum is directed towards the posterior wall of the vagina, which can generate the condition known as rectocele..

Different types or degrees

Rectal prolapse may appear in different degrees depending on which parts of the lower third of the intestine protrude.. In this sense we can find different variants.

1. Partial/mucosal rectal prolapse

Rectal prolapse in which only a part of the lower rectal mucosa protrudes, not being affected other parts of the rectum or intestine. It is the most common in children.

2. Complete first degree rectal prolapse

Type of prolapse in which the entire wall of the anal canal protrudes, acting as the outer layer of the prolapse without containing peritoneum..

3. Complete rectal prolapse of the second degree

The most common. The anus remains in its usual position, with only the rectal mucosa protruding as the external wall and the deep part of the peritoneum. In this case the prolapse contains in its interior part of the small intestine, having a cavity in the shape of the rectum.having a cavity in the form of a sac.

4. Complete third degree or occult prolapse

The upper rectum and distal sigmoid invaginate or a sliding of a part of the colon or rectum into another, making the prolapse something hidden and not visible from the outside. This is the least frequent of this type of problem.

Causes of this problem

The causes of rectal prolapse can be very diverse, the direct cause being the loss of support of the lower part of the digestive system.. The origin of this loss of support is not always completely clear, but it has been observed that it tends to appear in people who meet certain conditions or perform situations of considerable effort.

Possible reasons for this loss of attachment may include malformations, hyperplasia of the colon or pelvic problems that allow a hernia to develop. It can also appear in situations of continuous strain of the anus or abdomen, such as diarrhea or constipation, or even chronic coughing.

On the other hand, its appearance has been observed in women after childbirth.. Likewise, muscular or nervous problems, worm infections or cystic fibrosis have also been considered possible causes of this condition.

Treatment

Rectal prolapse is a problem that can become serious, but whose treatment can vary greatly depending on the severity with which it comes to consultation or the degree and tissues that protrude. It should always be a procedure carried out by physicians.

When we are facing a partial and mild prolapse, the treatment can only be to gently reintroduce the rectum into the anus, usually with the help of a compress to push the mass back into the anus..

Sometimes treatment of the causes can solve the problem, at least in children. For example, in cases of constipation, laxatives can be used.

In adults or in severe cases surgical intervention may be necessary to reposition and fix the matter of the digestive system and the muscles that hold them in place. This surgery can be at the abdominal or perineal level, and there are different types of intervention. However, this type of intervention has its risks.

Bibliographic references:

• Avendaño, E.O. (1968). Rectal prolapse. Proctology. 1st Edition. Editorial Impresiones Modernas S.A. Mexico, D. F., pp. 138-45.
• Charúa, L. (2016). Rectal prolapse. [Online]. Available at: http://someal.org/wp-content/uploads/2016/05/PROLAPSO-RECTAL-DR.-CHARUA.pdf
• Kliegman, R.M., Stanton, B.F., St.Geme, J.W. & Schor, N.F. (2016). Surgical conditions of the anus and rectum. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier.