Rectal prolapse treatment. Prolapse of the rectum in women, children, men - causes, treatment, degrees. Examination in the examination chair for rectal prolapse

Rectal prolapse is not a very common problem, but in recent years there has been a tendency to increase it. Not being life-threatening (except in cases of collapse), the disease, however, delivers a number of significant inconveniences. Therefore, patients should be informed in order to take timely preventive and treatment measures.

A condition characterized by:

1. complete or partial prolapse of the rectum.

In this case, it is possible to diagnose using an external examination of the patient (visualization of the prolapsed intestine outside the anus). The disease is also called rectal prolapse.

In pathology, stretching of the lower intestine (terminal zone) is observed. Due to its excessive mobility, pain appears during defecation. We are talking about a visible section of the intestine up to several tens of centimeters in length.

Note. The disease is not considered life-threatening. At the same time, its course can acquire a severe debilitating form, and the symptoms negatively affect the patient's psyche due to a significant decrease in the quality of life.

Prevalence of rectal prolapse

Rectal prolapse is not a common pathology, if we take its percentage in relation to other proctological pathologies (less than one percent). Diagnosis in patients of all ages, including babies, forces doctors to take serious preventive measures. It is also noticed that men are more prone to the manifestation of this pathology than women.

Why? The nature of many professional occupations for men is traditionally associated with a number of physical activities.

Women are less prone to manifestations of the disease due to the structure of the pelvis and the natural ability to keep the rectum in a stable position well.

The main causes of rectal prolapse

The condition can be triggered by many components.

Among them, the most likely are:

• Problematic bowel movements, forcing a person to strain with great effort.
• Severe birth process in women with possible ruptures of the perineum and anus.

• A number of surgical operations with characteristic localization.

Relationship between the anatomical structure of the digestive tract and diseases

Specific features of the structure of the gastrointestinal tract and pelvic organs, as the cause of the development of rectal prolapses:

• Altered pelvic floor due to muscle pathology.
• A significant increase in pressure inside the peritoneum.
• Decreased functions of the sphincter of the anus.
• Incorrect configuration of the deepening of the uterus and rectum (in women).
• Weakening of the muscles that hold the intestine in a stable position.
• Abnormally long sigmoid colon (congenital pathology).
• The location of the coccyx and sacrum is strictly vertical.

hereditary cause

Scientists are actively investigating the factor of genetic predisposition. The percentage of diseases associated with heredity is quite high.

Sexual preferences and related pathologies

Of particular note, as a provoking factor, non-traditional ways of sexual satisfaction. This is a systematic and painful stimulation of the anus. The result is pain and bowel prolapse.

Dysfunction of the pelvic organs

As a provoking factor, you need to pay attention to:

1. on the general dysfunction of the pelvic organs (symptoms - urinary incontinence and organ prolapse);
2. a number of neurological diseases. Damage to the spinal cord or pathological processes in it are often accompanied by partial or complete rectal prolapse.

Important. It should be noted that in each case it is difficult for physicians to determine the only cause of the pathology. Most often we are talking about a number of negative conditions that contribute to the development of the disease. Their accurate diagnosis is important in determining effective medical care.

Signs and different stages of the disease

In proctology, the following stages of the course of the disease are recorded:

• Prolapse of an insignificant portion of the intestinal mucosa from the anus, eversion of a small part of the membrane during defecation.
• The process of loss of all layers of the anal region.
• Complete prolapse of the intestine (anus does not fall out).
• Prolapse of the rectum and anus.

The mechanism of development of rectal prolapse and the symptoms of rectal prolapse at each stage

Description of the stages of the disease with the main features.

Rectal prolapse (prolapse of the rectum) and hemorrhoids. Similarities and differences between diseases

The symptoms of these diseases are largely similar - bleeding and prolapse of part of the rectum from the anus. Because many do not see the difference.

However, these pathologies show significant differences.

Haemorrhoids

The nodes of the rectum, which are formed near the anus, fall out.

Rectal prolapse (rectal prolapse) - unlike hemorrhoids

There is a prolapse of a part of the rectum, the localization of which is determined at the top of the anal canal.

How to distinguish hemorrhoids from intestinal prolapse?

Distinguish one pathology from another by the location of the mucosal folds. Hemorrhoids are characterized by longitudinal, and for prolapse of the intestine - a transverse type of fold.

Clinical picture of hemorrhoids

Rectal prolapse and its symptoms

The clinical picture of the disease can vary from a slow, sluggish and long-term development with blurred signs to a sudden, abrupt and unpredictable manifestation.

How can a rectal prolapse appear suddenly?

An unexpected prolapse of the rectum can come as a complete surprise to a person, for example, during heavy lifting, when intra-abdominal pressure rises sharply. The same is sometimes noted even with a sharp cough, sneezing, laughing, etc.

The rectum prolapsed. What happens with this?

The mesentery is stretched, with the help of which the abdominal cavity is connected to the back wall of the abdomen. In view of this, a person experiences acute pain syndrome. The results are unpredictable - it's a shock, sometimes even a collapse.

reference . Collapse is a condition in which blood pressure drops sharply, vital organs decrease due to acute vascular insufficiency. Medical help required!

However, this situation is extremely rare. Usually, prolapse is more characteristic of gradual development. At first, the rectal mucosa falls out only occasionally and with a strong effort during defecation. She is self-correcting without problems after getting rid of feces.

How is the progression of the disease with rectal prolapse?

In the future, if measures are not taken, the progression of the disease is noted. The rectum more and more often falls out during various physical exertions and does not return to its natural position on its own.

The patient is forced to perform this operation manually.

Symptoms of worsening disease with rectal prolapse

Signs that indicate the further development of pathology:

• Stable disturbing feeling of being in the anus of a foreign body.
• Frequent and unreasonable urge to defecate.
• Unpleasant, varied, often painful sensations in the anus.
• Voluntary release of gases and feces.

Factors such as physical exertion, walking and defecation contribute to increased pain. This symptom usually disappears after the rectum is manually repositioned.

Clinical picture of the inflammatory process in rectal prolapse

Inflamed areas of the mucosa fall out and often damage the blood vessels. The process is aggravated by the fact that the patient suffers from bleeding and mucus.

In the future, there may be:

• foci of redness;
• significant mucosal edema.

Dangerous Complications

Worsening of the course of the disease

A long-term pathology in the absence of competent treatment leads to functional disorders in the genitourinary system. Symptoms - the frequency of false urge to urinate, the difficulty and discontinuity of the process itself.

The psychological aspect of rectal prolapse

The symptomatology of the disease is characterized by the progression of negative dynamics. The patient does not have the ability to control the process of excretion of feces and gases from the body. In view of this, the patient's psyche is subjected to stable stress. Phobias of the moral and sociological spectrum are added to the physical costs.

It is quite natural that when the deformed intestine is repositioned, various complications are possible. One of these unpleasant consequences is its very painful infringement.

What happens with this?

You should be wary of:

• circulatory disorders;
• sudden development of edema;
• occurrence of tissue necrosis.

Peritonitis is a dangerous consequence of rectal prolapse

If a loop of the small intestine is pinched, a path is opened for the development of peritonitis and acute intestinal obstruction, which poses a direct threat to the patient's life.

Chronic constipation and bowel prolapse

Bowel prolapse often leads to chronic constipation. This means the need to push with each act of defecation. The result is an increase in unwanted pressure on the abdominal cavity and further accelerated development of the pathology.

Other complications of bowel prolapse

A number of additional negative consequences:

• significant deterioration in the quality of human life;
• weakening of the protective functions of his body;
• vulnerability to a whole list of diseases;
• decrease in working capacity, up to the impossibility of performing the simplest and most natural functions;
• the manifestation of such mental abnormalities as nervousness, irritability, apathy and loss of interest in life.

Diagnostics

A patient with complaints of rectal prolapse is prescribed a serious comprehensive examination. It is necessary to visualize the anorectal region and the prolapsed intestine. But this can be done without problems only with the advanced form of the disease.

If rectal prolapse does not yet have a pronounced form of manifestation, the patient will have to squat down, imitating pushing movements. The diagnosis is confirmed if the intestine appears from the anus.

Examination in the examination chair for rectal prolapse

For a patient sitting in a special chair, specialists (proctologist) conduct a digital diagnosis of the condition of the anus.

Important:

• identify possible internal prolapse of the intestine, which is not visually visible;
• evaluate the elasticity and relief features of the mucous membrane;
• check the functionality of the muscles;
• determine how much the sphincter is capable of contractions in general.

The presence of prolapse is evidenced by an increased volume of the intestine when simulating the expulsion of feces and a reduced volume in the knee-elbow position.

Prolapse of the rectum. Instrumental research methods to confirm the diagnosis

X-ray method

With the help of defectography, it is possible to study the features of the structure and functioning of the lower rectum, to analyze the activity of the muscles and the possibilities of the tone of the intestinal wall. The technique is based on taking a series of pictures during the efforts characteristic of defecation.

Sigmoidoscopy

In this visual way, the state of the intestinal mucosa is assessed, and possible negative manifestations of internal prolapse are also analyzed.

Colonoscopy

The technique is aimed at finding out the causes of rectal prolapse, specific pathologies that led to it. From the detected ulcers, a small part of the affected tissue (biopsy) is taken for a detailed laboratory analysis in order to exclude an oncological disease.

Anorectal manometry

With its help, it is possible to assess the functional ability of the anal sphincter to complete contractions.

Treatment

In proctology, the method of treating a disease is based on examination indicators and is determined by specific medical tasks.

All therapeutic measures are divided into two areas:

1. conservative
2. Surgical.

Conservative treatments for rectal prolapse

Justified in the early stages of the manifestation of pathology. Assign only to patients who have reached a young or middle age.

The task of therapy is the cardinal elimination of the causes and conditions that led to the development of prolapse.

The patient needs:

• identify and cure all existing pathologies of the colon;
• normalize stool;
• be sure to eliminate constipation;
• exclude physical loads, especially lifting any heavy loads;
• to secure sexual life as much as possible (ban on any form of anal sex).

Attention! It is very important for the patient to choose the right physical therapy technique. The patient needs to allocate time every day to perform special exercises that help strengthen the muscles of the perineum and pelvic floor.

Other types of conservative treatment for bowel prolapse

The patient may be given:

• a course of injections (sclerosing drugs);
• special massage with penetration into the rectum;
• physiotherapy (muscle stimulation with electric current).

Predictions of conservative treatment for rectal prolapse

Conservative technique, unfortunately, does not allow to achieve a guaranteed result in all patients. Statistics confirm recovery in only a third of patients. Two thirds need surgery.

Important. The success of treatment and the absence of various complications depend on the stage at which the patient was operated on. The chance of a positive prognosis is greater for those who seek medical help when the first alarming symptoms are detected.

Surgical operations

Proctology is a direction in which the methods of surgical intervention are improving and becoming more complicated every year. Today, about five dozen different types of surgical operations are used to eliminate rectal prolapse.

Why?

The choice of a particular technique of surgical intervention depends on the specific task.

The operation depends on factors such as:

• the degree of development of the pathology observed in the operated patient;
• his individual characteristics;
• specific age;
• well-being.

Main directions (surgical operations):

• Operational complex for the removal of a section of the rectum that falls out.
• Removal of a specific section of the colon.
• Large complex of plastic surgery. Surgery is performed to suture the rectum. It is also possible to correct some muscles in the pelvic floor and intestinal canal.
• Combination of several types of operations.

The right choice of surgery

In modern surgery, the most common operation is the so-called suturing of the rectum. This technique allows her to be less traumatized. Patients usually endure such an operation without any problems.

The execution technique can vary from suturing the intestine to the site of the vertebral ligament to fixing it with a mesh (Teflon) to the sacrum.

Local areas of penetration:

1. Abdominal cavity.
2. Crotch.

Laparoscopy - a modern method for the treatment of rectal prolapse

There is also an improved bloodless technique (laparoscopic) with an accelerated recovery period, with a minimal risk of complications.

What does the correct choice of operation allow us to hope for? Predictions for rectal prolapse

The patient has every chance to eliminate the main cause of the disease and restore the efficiency of the colon.

Forecasts for the majority of operated patients are positive:

• complete recovery;
• elimination of symptoms of the disease;
• improvement of physiological well-being;
• elimination of prerequisites for psychological stress.

After surgery, the anal sphincter and its performance gradually return to normal. Improves his tone. All functions of the gastrointestinal tract are normalized.

When can the result of the operation be assessed with sufficient accuracy?

The specific result can be judged only one year after surgery.

Positive result of treatment for bowel prolapse

The positive dynamics are directly influenced by such important factors as:

• strict daily stool control;
• measures to prevent constipation;
• specialized diet.

Rectal prolapse and certain categories of patients. Explains the proctologist

A special approach in the treatment of the disease requires such certain categories of the population as women during pregnancy, children, adolescents, elderly and senile people.

Conservative therapy is not effective, for example, in relation to the last group listed above. It requires a careful choice of sparing forms of surgical intervention, including the so-called Delorme operation.

Pregnant women, on the contrary, are prescribed only conservative methods of drug treatment, since surgical intervention is justified only after a certain period after childbirth.

Children, as a rule, are not sent for surgery. Prolapse of the rectum in them for a long time requires the determination of conservative forms of treatment with strict consideration of provoking factors.

Rectal prolapse in children. Conservative therapy

This type of disease occurs in children usually between one and four years of age. Boys are more susceptible to pathology than girls (the ratio is two to one).

Rectal prolapse can occur as a complication after certain diseases in the stomach and intestines. In this case, an increase in intra-abdominal pressure is observed.

Provoking factors are systematic constipation and diarrhea.

Attention should also be paid to the possible genetic predisposition, past illnesses, diet and type of nutrition, the factor of possible degenerative changes in fiber and muscle mass in the pelvic floor.

Initial symptoms in children

It is quite difficult to notice the primary signs of pathology. During defecation, the mucous membrane turns out of the anus, and after it immediately returns to its natural position.

To make sure there is a problem, parents need to check during stool if the child has a red rosette of mucous membrane that falls out of the anus. If found, immediate action must be taken.

Disease progression in children

Be prepared for worsening and worsening symptoms, especially if left untreated. The child may develop hypotension of the pelvic muscles. Soon the rectum will begin to fall out with each act of defecation, but it will no longer be able to set itself back. It is necessary for parents to return it to its place manually.

Further development of pathology:

• prolapse of a large section of the intestine, even with the usual cough, laughter, weight lifting;
• fecal incontinence due to insufficient muscle functionality of the sphincter;
• infringement of the prolapsed intestine, which is dangerous not only for the health of the child, but also for his life.

In the latter case, emergency surgery is necessary.

In other cases, the child is prescribed one of the many methods of conservative or sclerosing therapy.

Tasks of conservative treatment in children

With the help of conservative therapy it is necessary to achieve:

• normalization of the chair;
• restoration of normal functioning of the gastrointestinal tract;
• proper digestion of food.

It is important for a child to choose the type of diet that is most suitable for him, taking into account the need for a relaxing or fixing effect, as well as a number of medications that would help stop inflammation in the intestinal mucosa.

Removing the urge to empty the bowels!

It is very important! It is necessary to gradually adjust the functionality of the musculature of the child's pelvis. For this, any effort during defecation should be excluded. The baby should be accustomed to a chair in a supine position - on the left or right side. You can also defecate while lying on your back.

As you already understood, parents will have to show delicacy, patience and perseverance. The method of defecation described above should be practiced for about four months.

Over this time:

• the functionality of the intestine is restored;
• undergoes a full course of the natural healing process;
• muscles are strengthened and shortened;
• all prerequisites for rectal prolapse are eliminated.

Sclerotherapy

This technique is based on the dosed introduction of a certain sclerosing substance into the fiber with localization near the rectum.

What for?

The fact is that such substances are capable of causing a targeted and controlled inflammatory process. In the right place, edema occurs, and then cell necrosis.

Result

Atrophied and diseased tissues are replaced by connective and cicatricial neoplasms. Sclerosis of tissues occurs, and this is the possibility of a strong fixation of the rectum.

Negative aspects of the technique

In surgery, this method of dealing with rectal prolapse is not used so often. The reason is painful injections, which the child has to do in large quantities. A number of unpleasant complications are also possible.

rectal prolapse. Disease prevention in babies

Priority attention should be paid to the exclusion of any stool disorders in the baby, ensuring a correct and balanced diet. Control the defecation process. The child should not sit on the potty for a long time. Read and play on it. Train him to empty quickly.

conclusions

Only a medical specialist has the right and sufficient experience to choose the right medical tactics in each individual case. The conclusion is issued after the examination, which should be as comprehensive as possible.

Counseling for rectal prolapse is done by a proctologist or surgeon. A gynecologist examines women with rectal prolapse caused by birth trauma.

Remember that the success of treatment directly depends on timely diagnosis and effective medical care.

Important. Do not self-medicate - it is life threatening. Do not trust charlatans and so-called traditional medicine specialists. If you have this disease, you will need a very serious course of treatment.

Your health is in your hands. Seek help in time. Lead a healthy lifestyle. Look at the world with joy.

rectal prolapse(otherwise Rectal prolapse) is a disease characterized by partial or complete presence of the rectum outside the anus. The disease is accompanied by bleeding, pain. Prolapse of the intestine at the beginning of development may resemble hemorrhoids. After examination, the doctor makes an accurate diagnosis.

Rectal prolapse: causes

Prolapse occurs for various reasons:

1. Difficult childbirth.
2. Operational intervention.
3. neurological diseases.
4. hereditary factor.
5. Anatomical structure of the pelvic and intestinal organs.

Rectal prolapse is a rather rare pathology, it occurs only in 0.5% of all proctological patients.

There is no main reason why the intestine crawled out. All factors can provoke the disease individually or in combination.

Rectal prolapse: symptoms

To begin with, rectal prolapse should be diagnosed. The symptoms of the disease help to establish the correct diagnosis. At the initial stage, hemorrhoids, prolapse of the rectum are almost identical in signs.

Symptoms may appear gradually or unpredictably. A sharp exacerbation of rectal prolapse is provoked by such factors:

• sneezing
• lifting heavy objects;
• increased pressure on the walls of the abdominal cavity;
• strong straining.

There is a sharp pain in the peritoneum, pain shock is possible.

If the disease develops gradually, the clinical picture worsens in stages. At first, the rectum falls out during straining. But over time, the mucosal area returns to the anus. Then it is set by hand. This condition occurs more and more often, at any load.

A prolapse of the rectum in a person can be triggered by a number of factors.

Symptoms:

1. Fecal incontinence.
2. Bloating.
3. False urge to defecate.
4. Feeling of discomfort in the perianal area.
5. Sensation of a foreign object.

Pain is aggravated during movement and load. An improvement in the condition occurs after the fragment is repositioned. If the blood vessels are injured, bleeding may develop. The mucous membrane of the organ becomes inflamed, ulcers can be seen on its surface. In the absence of therapeutic measures, the symptoms worsen. There are problems with urination, bloating of the intestines. The mental state of the patient is disturbed.

Not everyone knows if the gut has fallen out, what to do about it. In case of incorrect self-reduction of a fragment of an organ, its infringement is not excluded.

This condition is characterized by signs:

• tissue death;
• edema;
• bleeding.

Persistent constipation can cause prolapse. Fecal masses are compacted. Defecation is difficult. A person has to push to go to the toilet, which increases pressure on the walls of the abdominal cavity.

Proctologists say that rectal prolapse may occur as a result of a genetic predisposition or depend on a person's sexual orientation.

Forms and stages

Rectal prolapse has 4 degrees:

1. A small portion of the fragment falls out only during defecation. Manual adjustment is not required.
2. The fragment falls out during defecation. He sets on his own, but not as fast. Sometimes there is bleeding.
3. The disease provokes any physical activity, even coughing. Self-management is not possible. Typical symptoms are bloating, bleeding, and fecal incontinence.
4. The process of tissue necrosis begins. The patient complains of a strong in the perianal region.

There are 4 stages:

1. A fragment of the mucosa is everted.
2. All layers of the body fall out.
3. The rectum came out completely.
4. The anus falls out.

Intestinal prolapse with hemorrhoids can be confused by symptoms. In both cases, is observed. But with hemorrhoids, nodes form at the anus and later they fall out. Mucosal folds will help clarify the diagnosis.

According to the mechanism of development, several degrees of rectal prolapse are distinguished

How to treat rectal prolapse?

There are 2 ways:

1. Conservative. It is effective at stage 1 of the disease. To begin with, the reasons for which the intestine fell out are eliminated. It is important to strengthen the muscles of the perineum. For this, the doctor prescribes special exercises. , physiotherapy also speeds up recovery.

1. Operational. They come running when an organ falls out. There are several operations that differ in technique:

• deleting a fragment;
• hemming of the fallen area;
• plastic;
• manipulations on the dropped fragment;
• combined.

Most often, fixing the dropped fragment is used. Then you can resort to plastic.

Treatment for rectal prolapse can be conservative or surgical.

Therapy of certain categories of patients

What to do if the rectum crawled out from a child, the elderly and pregnant women, not everyone knows. In children, the disease occurs between the ages of 1 and 4 years. Boys are more susceptible to the disease. The disease develops as a consequence of disruption of the gastrointestinal tract, increased pressure on the walls of the abdominal cavity. Genetic predisposition to the disease is also important.

The initial symptoms are inversion of the mucosa from the anus, while going to the toilet. Then the plot is returned back. In the absence of treatment, the symptoms are aggravated, the mucosal area falls out with any effort. In case of infringement, an urgent operation is necessary.

When treating children, it is first necessary to eliminate provoking factors. The stool is normalized, the work of the digestive tract is restored. A special diet and medications are prescribed to improve bowel function. It is important to avoid straining during bowel movements. To do this, the child empties the intestines on the back or side. Treatment takes a long time. But in 3-4 months, muscle strengthening occurs, and the disease is eliminated.

Apply if necessary. The sclerosant is injected into the tissue adjacent to the final part of the digestive tract. Initially, inflammation develops, the cells partially die. Then the damaged tissues are replaced by connective tissue. The mucosal fragment is tightly fixed. But this method is dangerous for its complications.

The most widespread operations aimed at suturing the intestine

If conservative therapy has not brought the desired effect to pregnant women, the operation is prescribed after childbirth. For the treatment of the elderly, only the Delorme operation is used. The doctor cuts off the mucous membrane of the prolapsed fragment. Then the doctor puts special gathering sutures on the muscle wall. Manipulations are carried out from the perineum. Since access to the abdominal cavity is limited, the operation is less traumatic.

If the intestine crawled out, what to do in each individual case is decided by the doctor.

Rectal prolapse: treatment at home

At an advanced stage, traditional medicine is not advisable to use. Home therapy aims to achieve 2 goals:

1. Strengthening the pelvic muscles.
2. Prevention.

If the rectum came out in an adult, what should I do? To get started, make an appointment with a proctologist. He will inspect.

Medications eliminate provoking factors:

1. Laxatives - for constipation. Guttalax, Duphalac, glycerin suppositories.
2. Antidiarrheal - for chronic diarrhea. "Imodium", "Smekta".

During treatment, it is recommended to abandon physical activity and bad habits, not to strain during bowel movements. If the cause of the disease is a decrease in the tone of the pelvic muscles, it is recommended to do special exercises. You can compress and decompress the sphincter. Repeat 10 times per session. To perform another exercise, you need to lie on the floor, bend your legs at the knees, feet on the floor and raise your pelvis above the floor. At the same time, you need to draw in the muscles of the perineum.

Traditional medicine recipes:

1. Calamus roots. They make an infusion. 1 tsp collection is filled with 200 ml of water. Insist 12 hours. Before taking, you need to strain the infusion and warm it up. Take 2 sips after meals.
2. . 1 tsp collection pour 200 ml of boiling water. Pour into a large container. You need to sit down over it so that the steam reaches the anus.

• do not overexert;
• follow a diet;
• avoid constipation.

These measures will help prevent complications.

Rectal prolapse accounts for only 0.5% of all proctological diseases in adults, so this problem is considered rare. In medicine, it is called rectal prolapse and is classified as a serious pathology that requires complex therapy. This disease is expressed by partial or complete prolapse of the rectum from the anus.

The likelihood of rectal prolapse is different. In the USA, for example, it affects mainly women over 50 years old, while in the post-Soviet countries, women are diagnosed with prolapse 5 times less often than men.

What is rectal prolapse and why is it dangerous?

Rectal prolapse is not a life-threatening condition, but it brings a lot of inconvenience to the patient's life: constant physical and psychological discomfort, inability to do usual things, etc. The condition is characterized by weakening and stretching of the terminal intestine (sigmoid and rectum) and increasing their mobility.

Sometimes, with a prolapse of the rectum, there is a sharp tension in the mesentery connecting the anterior and posterior abdominal walls. At this moment, the patient experiences severe pain, which can cause pain shock or collapse. These conditions are life threatening and require urgent medical attention.

In adult patients, rectal prolapse is directly associated with intestinal intussusception, when one part of it descends and is introduced into the lumen of the lower intestine.

At the same time, discomfort is accompanied by the appearance of rounded formations in the anus, which can be mistaken for hemorrhoids, if you do not know the features characteristic of prolapse. With the progression of the disease, there is a prolapse of the rectal mucosa from the anus, and with progression, the submucosal and muscular layers.

If rectal prolapse treatment is not started on time, there is a risk of complications:

• acute intestinal obstruction;
• peritonitis;
• intestinal necrosis;
• psychological and mental disorders (they develop against the background of constant stress).

In order not to bring the condition to a critical one, if you suspect a prolapse of the rectum, you should not wait for the disease to go away on its own. It is even more dangerous to use non-traditional treatment at home. The only way to get rid of rectal prolapse is to contact a proctologist and undergo complex therapy for the disease.

Symptoms of prolapse and its stages

The main symptoms of rectal prolapse vary depending on the stage of the disease. Common to all stages of disease progression are called:

• difficulty with bowel movements or spontaneous bowel movements;
• sensation of a foreign object in the rectum or anus;
• dull pain in the lower abdomen, anus, lower back and groin;
• anal bleeding of varying intensity.

The intensity of these symptoms varies depending on the stage of the disease. The deeper the changes, the stronger they appear.

There are other signs by which a doctor can determine how far rectal prolapse has gone:

1. At the first stage, the rectal mucosa prolapses by 1-2 cm, and the anus remains in a normal state. Prolapse occurs during bowel movements, the rectal mucosa returns to its normal position on its own, but the uncomfortable phenomena described above persist for several hours.

In the second stage, the prolapse is more pronounced, in addition to the mucosa, the submucosal layer of the rectum also descends. Reduction occurs independently, but more slowly than in the first stage. The anus remains in a normal state, retains the ability to contract. Discomfort in the rectum is complemented by occasional scanty bleeding.

1. At the third stage, the weakening of the sphincter is included in the pathological process, because of which it cannot hold the rectum. It turns out enough by 10-15 cm, including when coughing, and cannot return to the physiological position on its own. On the everted mucosa, foci of necrosis and superficial damage (erosion) are visible. In addition to increased bleeding, patients are concerned about gas and fecal incontinence.
2. In the fourth stage, the symptoms of the disease become even more severe. In addition to the rectum, the anus and parts of the sigmoid colon are everted. The falling part reaches 20-25 cm. This happens even at rest. Extensive areas of necrosis are visible on the mucosa, the patient is tormented by constant itching and pain. Repositioning the rectum is very difficult.

The symptoms of this disease are similar to those of hemorrhoids, so they are often confused. The only way to distinguish between rectal prolapse or hemorrhoids is to carefully examine the formation that has fallen out of the anus. Consider in detail what rectal prolapse and hemorrhoids look like, and how they differ, the photo below will help.

If the folds on it are located longitudinally, and the color is flesh or pale pink, this is a hemorrhoid, while the transverse folds and the bright red color of the formation indicate prolapse of the rectum.

Causes of pathology

The main cause of rectal prolapse is intestinal intussusception. however, not only it plays a role in the development of the disease. It was found that the main provocateurs of the disease are the anatomical or genetic features of the body:

• weak muscles located in the pelvic floor, which cannot cope with the load during bowel movements and gradually stretch;
• abnormal location of the uterus relative to the rectum, in which the depth of the parietal peritoneum becomes increased;
• elongated mesentery (a ligament connecting the posterior and anterior walls of the peritoneum);
• elongated sigmoid colon;
• anomalies in the structure of the sacrum and coccyx when they are located vertically;
• weak anal sphincter.

These causes are related to congenital pathologies, but they can also be of a traumatic nature. Thus, weakening of the muscles of the pelvic floor and anal sphincter can occur after childbirth (only natural) in women. Surgical interventions, injuries of the anterior abdominal wall, perineum, rectum or anus can affect the holding capacity of muscles and ligaments.

Weakening of the sphincter and ligaments holding the rectum can also occur with regular anal sex.

According to statistics, in men, prolapse occurs more often due to the anatomical features of the body and due to excessive physical exertion. Among the female population, the causes of rectal prolapse are associated with an increase in the load on the pelvic floor muscles during pregnancy and their stretching during childbirth. Moreover, pathological changes do not become noticeable immediately, but after several years or even decades, since most of the patients with such a diagnosis are aged 50 years and older.

Diagnosis of the disease

Diagnosis of rectal prolapse includes an initial examination, during which the doctor (most often a proctologist) assesses the condition of the anus and rectum visually. In addition, a simple test is performed: the patient is asked to squat down and strain a little, as during a bowel movement. If at the same time the sphincter opens and the rectum comes out, proceed to a comprehensive instrumental examination, which includes:

• defectography - an x-ray study that can be used to assess the anatomical structures in the pelvic area and the tone of the pelvic floor muscles during the stimulation of defecation;

• sigmoidoscopy and colonoscopy - a visual examination of the rectum and intestines using an instrument equipped with a camera and a light source, during which you can take tissue for analysis or take a photo of individual parts of the digestive tract;

• manometry - measurement of the tone of the anal sphincter.

Based on the results of the examination and clarification of the anamnesis, the proctologist will be able to find out the causes of rectal prolapse and select a treatment.

How to treat rectal prolapse in adults

To eliminate the prolapse of the rectum, conservative and surgical treatment is used. Patients are advised to follow a diet to normalize the stool, perform a set of exercises to strengthen the muscles of the pelvic floor, anal sphincter and perineum. To avoid the progression of the disease, physical activity is completely excluded.

Medical therapy

Conservative treatment is effective in the first stages of rectal prolapse, when the rectum is retracted on its own, and the disease occurred no more than 3 years before contacting a proctologist. Goals of therapy:

• reduction of unpleasant symptoms;
• exclusion of constipation and diarrhea;
• restoration of the tone of the anal sphincter and rectum.

the list of drugs for this disease is not numerous. In most cases, stool-regulating drugs are prescribed, such as laxative suppositories or oral preparations (tablets, powders for preparing drinks). For severe pain, pain medication may be used. It is advisable to discuss this issue with a proctologist.

Important! Laxatives should be used with extreme caution and only with the permission of the attending physician. Attempts to soften the stool without chronic constipation can lead to increased stress on the rectum and rectal sphincter.

If a prolapse of the rectum is observed in a woman during pregnancy, the choice of drugs is approached with extreme caution. Most of the drugs are contraindicated in this category of patients. To restore the stool, expectant mothers are recommended to use oil enemas or Microlax microclysters and drugs to normalize the function of the colon (Duphalac, Phytomucil). Consultation with a specialist is recommended for the selection of therapy.

Also, with rectal prolapse, sclerosis of the rectum is used. The method is conservative and is used mainly for the treatment of young people and children. During the procedure, the doctor injects a sclerosing drug based on 70% ethyl alcohol into the perirectal tissue, as a result of which it is partially scarred and better holds this section of the intestine.

Additionally, patients are prescribed a complex of vitamins with iron. It helps to restore general well-being and strengthen the immune system.

Surgical intervention

Surgical treatment is used at stages 3 and 4 of rectal prolapse, as well as with the ineffectiveness of conservative therapy. There are several methods for fixing the rectum in a physiologically correct position, and no doctor can say which operation is the most effective. All of them are divided into several groups and differ in the principle of impact on organs.

Methods of surgical treatment of total prolapse of the rectum:

1. Methods of narrowing the anus or artificial reinforcement of the external sphincter
2. Operations of rectopexy or attachment of the distal rectum to the fixed parts of the small pelvis
3. Colopexy techniques, i.e., transperitoneal fixation of the distal sigmoid colon to immobile pelvic masses or abdominal wall
4. Operations aimed at strengthening the pelvic floor and perineum
5. Methods of partial or complete resection of prolapsed intestine

Of the variety of surgical treatment methods proposed by various authors, only a few have passed the test of time, due to the high percentage of relapses in some cases, high trauma and many complications in others. To date, the most common for rectal prolapse are:

Operation Kümmel-Zerenin

A laparotomy (i.e., an incision in the anterior abdominal wall) is performed. The rectum stretched upward is sutured with interrupted serous-muscular sutures to the longitudinal ligament of the sacral promontory.

Walles Posterior Loop Rectopexy

Posterior loop rectopexy using a mesh was proposed by E.H. Wells in 1959. The operation can be performed in the usual way, i.e. with laparotomy and laparoscopically. After mobilization of the rectum and its tightening, the posterior wall of the intestine is fixed to the sacrum using a polypropylene mesh. According to different authors, the number of relapses after surgery ranges from 2% to 8%.

Operation Mikulich

It is a perineal excision of the prolapsed part of the rectum. The Mikulich operation is relatively simple in technical execution, less traumatic, the operational risk during its implementation is minimal, but it gives a large number of relapses, according to different authors, up to 60%. Given the advantages and disadvantages, it is performed mainly by elderly patients.

Operation Delorme (Sklifosovsky-Yuvarra-Rhine-Delorme-Bira)

It is based on the principle of removing the mucous membrane of the prolapsed rectum and subsequent plication of the exposed intestinal wall to form, as it were, a muscular clutch that prevents subsequent prolapse. This operation is also low-traumatic, the operational risk during its implementation is minimal, it can be performed under local anesthesia. Its disadvantage is the same as that of the previous operation - it gives a large number of relapses (according to different authors, up to 40%), although significantly less than the Mikulich operation. It is also performed mainly in elderly patients.

After surgery, local anesthetics and oral analgesics are used to reduce pain, anti-inflammatory and healing drugs (suppositories, ointments or gels).

In the postoperative period, it is important for the patient to follow a strict diet in order to prevent constipation or diarrhea.

Within a year after the surgical intervention, the patient should regularly come to see a proctologist.

Diet

The patient's diet includes foods with coarse plant fibers: fruits and vegetables, cereals, whole grain bread (preferably dried), sour-milk products. They should form the basis of the diet. Meals should be regular, without overeating. There should be at least 5 meals per day.

It is undesirable to include in the diet foods and dishes that irritate the intestines and cause constipation:

• marinades and pickles;
• smoked meats;
• fatty meats;
• legumes;
• mushrooms;
• fresh milk;
• foods fried in a large amount of fat or oil;
• citrus;
• spices, especially hot ones.

It is also worth giving up alcohol, coffee, carbonated drinks. They irritate the intestines no less than the products listed above. It is better to drink natural berry fruit drinks and compotes, kissels, herbal tea and water. The minimum volume of liquid that should be consumed per day is 2 liters.

Folk remedies

Traditional medicines are not particularly effective for rectal prolapse. They help eliminate unpleasant symptoms and avoid the appearance of irreversible changes in the rectum. Sedentary baths with decoctions of herbs will help to improve the condition:

• meadowsweet mixed with sage and knotweed;
• chestnut and oak bark;
• chamomile with calamus root.

Lotions from evaporated quince juice, cuff tincture or shepherd's purse will be useful. Also, home treatment involves taking herbal preparations inside. As a rule, these agents have stool-regulating properties. Decoctions of calamus roots and cuff shoots have a good effect.

Important! Traditional medicine is not an alternative to standard therapeutic methods. You can use the mentioned funds only with the approval of the attending physician!

Exercise therapy and other methods

If the cause of rectal prolapse is the weakness of the muscles of the anal sphincter or pelvic floor, proctologists recommend performing a set of special exercises daily:

• quickly or slowly compress and relax the anus;
• raise the pelvis from a supine position while simultaneously pulling in the stomach;
• "walk" on the buttocks.

Additionally, a digital massage of the rectum can be used. It is carried out only by a specialist, and helps to increase the tone of the muscles of the rectum and the muscles and ligaments that hold it.

At the time of therapy, the patient must observe thorough perineal hygiene. After defecation, it is advisable to use soft, slightly moistened paper. The ideal option is to wash with slightly cool water.

Consequences and prevention of rectal prolapse

In the absence of timely treatment, rectal prolapse can be complicated by tissue necrosis, ischemic colitis, trophic ulcers, proctitis, and even gangrene. Such diseases are observed with a long course of the disease with frequent prolapse of the rectum. In some cases, against the background of complicated prolapse, polyps are formed, which can then degenerate into a cancerous tumor.

The only way to avoid such problems is to prevent the occurrence of prolapse. It includes the exclusion of factors leading to an overstrain of the anterior abdominal wall and an increase in intra-abdominal pressure:

• prolonged cough;
• constipation
• weight transfer;
• prolonged standing or sitting.

If it was not possible to avoid the disease, it is necessary to treat it under the supervision of a proctologist and follow all his recommendations.

For basic information about rectal prolapse, the risk of its occurrence and methods of treatment, see the video.

One of the rare pathologies of the rectum is rectal prolapse or rectal prolapse. It can appear at any age and cause a lot of trouble.

General information about pathology

What is prolapse is the prolapse of all layers of the rectum through the anus. It happens that internal rectal prolapse is observed - a pathological condition in which invagination occurs (the introduction of one section of the intestine into the lumen of another section) of the rectum or sigmoid colon, but without going outside.

This pathology in men is diagnosed 2 times more often. Doctors explain this by the fact that women are less susceptible to physical exertion.

In rectal prolapse, the lower intestine stretches, becomes mobile, and falls out of the anus. The length of the fallen area can vary from 1 to 20 cm.

Causes

Several different reasons can provoke rectal prolapse at the same time.

Lead to prolapse of the rectum can:

Important! In infants, rectal prolapse may occur due to diseases accompanied by bouts of severe coughing, such as pneumonia, whooping cough and bronchitis.

Types and clinical picture of pathology

Rectal prolapse can occur in two ways:

1. By type of sliding hernia. With this development of the disease, due to chronic increased intra-abdominal pressure and weakening of the muscles of the pelvis, the abdominal pocket eventually shifts down and drags along the anterior wall of the rectum. With the progression of the pathology, the abdominal canal is stretched more and more and more loops of the rectum and sigmoid colon fall into it.
2. According to the type of intussusception, this is a pathological process in which the introduction of one segment of the intestine into another is observed, the resulting intussusception can be localized inside the body, or it can fall out through the anus.

The clinical picture of the pathology depends on the stage of the disease:

1. For the I degree of the disease, a slight eversion of the rectal mucosa during the act of defecation is characteristic. After its completion, the fallen section independently returns to its place. This stage is called compensatory.
2. II degree is called subcompensated. It is characterized by prolapse of the intestine, not only during emptying, but also during physical exertion. In this case, the appearance of pain and blood can be observed. The prolapsed area returns to the anatomical position much more slowly.
3. With the development of the III degree, prolapse can be observed during movement and adoption of a vertical position. At the decompensated stage, a significant prolapse of the rectum and the impossibility of its independent reduction are characteristic. The patient has frequent bleeding, possibly involuntary release of gases. With the development of deep decompensation, the mucous membrane undergoes necrosis.

Rectal prolapse can be acute or chronic.

The acute form develops unexpectedly, usually after a sharp jump in intra-abdominal pressure, which can be triggered by childbirth or excessive physical activity.

The rectum can fall out due to weakening of the pelvic muscles and anal sphincter, for example, due to a strong cough or a sharp sneeze. In this case, a large area (8-10 cm) of the rectum falls out through the anus, which is accompanied by severe abdominal pain.

Sometimes the pain is so strong that the patient may go into a state of shock.

The pain syndrome increases with motor activity. After the return of the fallen segment of the intestine, the pain disappears.

Important! It is impossible to set the prolapsed part of the intestine on your own, as this threatens to infringe it, as a result, the problematic segment swells, blood circulation is disturbed in it, and necrosis may develop.

The following symptoms may indicate the onset of rectal prolapse in acute form:

• sensation of a foreign object in the rectum;
• feeling of discomfort;
• tenesmus ().

Rectal prolapse can occur not only acutely, but also a gradual increase in symptoms of difficulty in emptying the intestines, chronic constipation develops, in which no laxatives help. Each bowel movement in such patients becomes painful, during which intra-abdominal pressure always rises sharply and as a result, the lower intestine falls out more and more.

Regardless of the form of pathology with rectal prolapse, the following main symptoms are observed:

If these symptoms appear, you should consult a proctologist.

Diagnostics

In making a diagnosis, the doctor is helped by taking an anamnesis and examining the patient. The examination of the patient consists of several stages:

1. The patient is positioned on an examination chair, the proctologist performs a digital rectal examination of the rectum. During the procedure, the doctor must differentiate rectal prolapse from hemorrhoids, pay attention to whether or not there are any neoplasms, for example, polyps, to an arbitrary contraction of the sphincter.
2. The patient is on the chair, and the doctor examines the prolapsed segment of the rectum - its shape, length, shade of the mucous membrane, notes the presence of an anorectal line.
3. The proctologist palpates the prolapsed part of the intestine in order to identify loops of the small intestine. If they are there, then by compressing the prolapsed fragment of the loop of the small intestine with a characteristic sound, return to the abdominal cavity, and the prolapsed segment will sharply become smaller.

The main method for diagnosing rectal prolapse is a digital examination.

When a patient has internal rectal prolapse, digital rectal examination and sigmoidoscopy (visual examination of the rectum and distal sigmoid colon) help in making the diagnosis.

After making a diagnosis, the doctor prescribes additional studies to identify the causes of the disease:

1. Endoscopic examination of the colon, which reveals diverticulosis, neoplasms of a benign or malignant nature.
2. If oncology is suspected, a histological examination is prescribed.
3. X-ray examination, which allows you to detect anatomical and functional abnormalities in the colon.
4. Sphinctrerometry, measure the tone of the obturator apparatus.

Differential Diagnosis

Differential diagnosis of rectal prolapse is carried out with such diseases as:

• hemorrhoids, prolapsed hemorrhoids have a different structure, on them the folds of the mucous are located along, and on the prolapsed rectum across;
• prolapse of large polyps or villous neoplasms, in this case, digital examination helps to make the correct diagnosis;
• internal rectal prolapse and a solitary ulcer are differentiated from endophytic tumors, this can be done using biopsy and cytological examination;
• internal prolapse of the rectum must be differentiated from rectocele.

Differential diagnosis is carried out using rectal digital examination and X-ray examination of the colon, which allows you to consider its structure and evaluate its functioning.

Therapy

At the initial stage, rectal prolapse is treated conservatively. These methods are especially effective in younger patients.

Treatment is aimed at eliminating the factors provocateurs of the disease.

Patients are prescribed medications to normalize the stool, depending on the clinical picture, these can be laxatives or fixing drugs, they give recommendations on physical activity, and if colon pathologies are detected, a treatment regimen is selected to eliminate them.

An important place in the conservative treatment of rectal prolapse is exercise therapy. There is a special set of exercises that you need to perform regularly, even after recovery, to reduce the risk of relapse:

• alternately strain the muscles of the perineum and anal sphincter;
• lie on your back with your legs bent at the knees and from this position raise the pelvis.

Physiotherapy and rectal massage may also be prescribed.

Important! It is advisable to prescribe conservative treatment of rectal prolapse if the pathology has been observed for no more than 3 years. The remaining patients are shown surgical therapy.

The operation is performed in chronic and severe pathology. The following surgical interventions may be prescribed:

• excision of the prolapsed area, such an operation is usually performed with dolichosigmoid;
• suturing of the rectum;
• removal of the lower part of the colon;
• plastic surgery, which allows you to restore the normal tone of the muscles of the pelvis and rectum;
• combined surgery.

Currently, resection of the prolapsed section of the rectum is rarely carried out and is prescribed only to certain categories of citizens and according to strict indications - severe disease and old age.

In modern surgery, the most effective operations are those performed:

• the Zerenin-Kummel method is the essence, which is in fixing the problem area to the longitudinal ligament of the spinal column;
• using the Ripstein method, during the surgical intervention, the dropped segment is attached to the sacrum using a Teflon mesh.

After that, plastic surgery can be performed.

Currently, surgical treatment is usually carried out by laparoscopic access, after which a long rehabilitation period is not required. Already for 4-5 days the patient is allowed to get up.

Complications

The most serious complication of rectal prolapse is the infringement of the prolapsed segment.

This can happen if the doctor does not set it back in a timely manner, or if the patient tries to do it himself.

If infringement, edema immediately forms, which will increase rapidly and it will become almost impossible to set the fallen fragment behind the anal sphincter. All this will lead to the formation of ulcers in the fallen area and its necrosis.

When the small intestine prolapses, inflammation of the peritoneum may begin or acute intestinal obstruction may develop, which can cause the death of the patient.

Important! Rectal prolapse is a dangerous disease. If adequate surgical treatment is carried out, then the prognosis is favorable, since according to statistics, 75% of patients manage to eliminate rectal prolapse. But in order to consolidate the effect of the operation, you must follow all the doctor's recommendations: limit physical activity, normalize bowel function, etc.

One of the most rare pathologies associated with the rectum is rectal prolapse. This condition is often referred to as rectal prolapse. This ailment, even with a fairly severe course, does not threaten the patient's life, but is accompanied by very unpleasant, debilitating symptoms that negatively affect the patient's mental state.

Physiology

Of all proctological patients, rectal prolapse is recorded only in 0.5%. The disease can develop in people belonging to all age groups. It is twice as rare in women as in men. Experts explain this by the fact that the representatives of the stronger sex are much more likely to undergo heavy physical exertion.

Prolapse of the rectum is a pathology in which the rectum completely or partially protrudes beyond the anus.

With rectal prolapse, the thermal, lower segment of the intestine becomes mobile, gradually stretches and eventually begins to fall out of the anus. The drop-down area can have different lengths, usually it varies from 1 to 20 cm.

Causes of rectal prolapse

Not always one specific reason leads to bowel prolapse, a combination of various factors can contribute to this. This pathology can be caused by:

• constant strong straining during bowel movements, usually this happens with constipation;
• diarrhea, in most cases it causes rectal prolapse in children, as a rule, they are accompanied by intestinal infections (salmonellosis, dysentery), dysbacteriosis, enterocolitis or dyspepsia;
• - tumors, polyps;
• transferred early operations, injuries of the pelvic organs, systematic non-traditional sex is also capable of leading to this pathology;
• rectal prolapse in women can be a consequence of difficult childbirth, complications in them, for example, trauma to the muscles of the anus, rupture of the perineum;
• lifting heavy objects, which is precisely why such a violation is characteristic of athletes and people engaged in heavy physical labor;
• neuralgic disorders - inflammation, paresis, paralysis, brain tumors, injuries, can cause a violation of the innervation of the muscles of the rectal sphincter and pelvis.

The causes of prolapse of the colonic lavage may lie in the individual anatomical features of the pelvis and intestines. They include:

• vertical position of the sacrum and coccyx;
• elongated mesentery and sigmoid colon;
• stretching of the muscles that hold the rectum;
• increased intra-abdominal pressure;
• abnormal changes in the pelvic floor muscles;
• decreased sphincter muscle tone.

Symptoms of rectal prolapse

Pathology can develop both suddenly and gradually. Sudden prolapse is usually caused by a sharp increase in intra-abdominal pressure. Excessive physical exertion, severe straining, even coughing or sneezing can lead to this. In this case, the prolapse is accompanied by such severe pain that it can lead a person into a state of shock.

Most often, rectal prolapse develops gradually. Initially, mucosal prolapse occurs only during the act of defecation, while it is reduced independently. After some time, the intestine ceases to adjust itself and the patient has to do it manually.

Symptoms of rectal prolapse are as follows:

• constant sensation of a foreign body in the intestines, false urge to defecate;
• a feeling of discomfort, pain that increases with bowel movements, heavy exertion, walking, with a sudden loss of severe pain in the lower abdomen;
• gas incontinence, feces, they are associated with weakness of the sphincter;
• mucous or spotting from the anus, they occur due to a violation of the integrity of the vessels;
• possible formation of edema, redness, ulcers on the intestinal wall.

With a long course of the disease and no treatment, there are problems with the functioning of the urinary system - intermittent, difficult urination, frequent urges. In case of incorrect or untimely reduction of the intestine, its infringement is not excluded. In such cases, blood circulation is disturbed in it, edema rapidly increases, which can lead to tissue necrosis.

What is the difference between hemorrhoids and rectal prolapse

It is worth noting that hemorrhoids and rectal prolapse have similar symptoms. Both for this and for the other disease is characterized by bleeding and prolapse of tissues from the anus. However, the difference between them is significant:

• with hemorrhoids of the rectum, formed near the anus;
• with prolapse, a part of the rectum, located above the anal canal, comes out.

One pathology can be distinguished from another by the placement of mucosal folds. With prolapse of the intestine, they are transverse, while with hemorrhoids, longitudinal folds are observed.

Rectal prolapse significantly impairs the quality of human life. In addition to local manifestations, the disease leads to a decrease in immunity, making the patient vulnerable to other diseases, he becomes irritable, nervous, and may lose interest in life.

Stages and forms of rectal prolapse

First of all, the disease is usually divided according to the mechanism of development. Specialists distinguish 4 degrees:

1. Prolapse of the rectal mucosa occurs only during emptying, while it immediately returns to its place.
2. The mucosa turns out during a bowel movement, it returns back itself, but very slowly. In this condition, minor bleeding occurs.
3. Prolapse is observed not only during bowel movements, but also during physical exertion. The bowel itself is no longer set. In this case, the condition is usually accompanied by frequent bleeding, gas and fecal incontinence.
4. The bowel may prolapse when the person is simply walking or standing upright. Necrotic processes can be seen on the mucous membrane, itching of the anus occurs, its sensitivity is disturbed.

There are also 4 stages of rectal prolapse:

• only the intestinal mucosa falls out, a small part of its membrane turns out when the intestines are emptied;
• there is a prolapse of all layers of the anal intestine;
• the intestine falls out completely;
• along with the intestine, the anus also falls out.

Almost all people suffering from rectal prolapse develop rectal sphincter insufficiency. This pathology is initially manifested only by gas incontinence. Gradually, the sphincter loses its ability to hold even liquid feces, and with a neglected degree, already dense stools.

Diagnostics

Rectal prolapse is usually easy to diagnose. It is often possible to establish the diagnosis after examining the anorectal region. If the disease is in the initial stages, in which the intestine is not visible, the doctor suggests the patient to strain, emitting bowel movements. If the intestine at the same time appears from the anus, the diagnosis is confirmed. In addition, to assess the relief and elasticity of the mucosa, muscle tone and the state of the sphincter, a finger examination is performed.

An instrumental examination may be required to clarify the diagnosis. The most commonly used for rectal prolapse is:

• X-ray examination . It makes it possible to evaluate the work of the rectum and its anatomical features, the tone and condition of the muscles of the organ;
• . With the help of it, the condition of the mucosa is visually assessed, the presence of complications is determined;
• anorectal manometry. Allows you to determine the quality of the anal sphincter;
• Colonoscopy. It is usually done in order to detect diseases that could lead to prolapse of the intestine.

: how is the procedure and how to prepare for it?

Treatment Methods

For the treatment of rectal prolapse, both conservative and surgical methods are used. Conservative therapy can give a positive result only in the initial stages of the disease. Surgical treatment of rectal prolapse is recommended when external protrusion is present or when conservative therapy fails.

• conservative therapy. It is primarily aimed at eliminating the causes of the disease - problems with stools, diseases of the colon, non-traditional sex, excessive physical exertion. The second task of therapy is to strengthen the muscles of the perineum and pelvic floor. This is done with the help of special exercises. Also, the patient can be prescribed physiotherapy, to stimulate the necessary muscles with electric current and rectal massage. Injections into the tissues surrounding the rectum are possible. There are no specific medications for the treatment of bowel prolapse.
• Surgery. At the moment, there are many different operations and their modifications that are used to treat rectal prolapse. These include hanging the rectum, removing part of the intestine, removing a prolapsed area, plastic surgery of the muscles of the intestinal canal or pelvic floor, etc. Surgery can be performed through an incision made in the abdomen or through the anus. The choice of one or another method of treatment depends on the individual characteristics of the patient, the degree of the disease, the presence of complications, etc.