Rectal prolapse, is a condition that often results in anxiety and misunderstanding, occurs when the rectum slides out of place and sticks out of the anus. It can cause discomfort, distress, and sometimes fear because people often wonder if rectal prolapse can kill you.
The short answer is no.
However, complications can make the condition worse. This article aims to demystify rectal prolapse, explaining its causes and symptoms and bringing clarity and hope to those suffering from it.
We’ll explore everything you need to know, from what doctors you need to see for rectal prolapse and treatment options to expert advice on managing this condition.
Rectal Prolapse Is Not Fatal
The concern surrounding the severity of rectal prolapse is understandable, but while it is a significant medical condition, it is not a life-threatening disorder.
Rectal prolapse happens when the rectum, which is the final part of the large intestine before the anus, loses its usual internal support. This makes the rectum protrude outward through the anus. Although this condition is usually not a medical emergency, it can cause significant discomfort.
Moreover, it can lead to substantial embarrassment and negatively impact the quality of life of those affected.
Rectal prolapse is a condition influenced by various factors. Statistically, it is more prevalent in older adults, with women over the age of 50 being particularly susceptible.
Research indicates that as many as 30% of women over 60 may experience some form of pelvic organ prolapse, which includes rectal prolapse. Furthermore, the likelihood of developing rectal prolapse increases with age, making it a significant concern for the elderly population.
Causes Of Rectal Prolapse
- Chronic Constipation: straining during bowel movements
- Childbirth: multiple or difficult deliveries can weaken pelvic muscles
- Ageing Process: Natural weakening of muscles and supportive tissues in older adults.
- Neurological Conditions: Issues like spinal cord injuries or multiple sclerosis affecting nerve function in the lower digestive tract.
Types And Symptoms Of Rectal Prolapse
Rectal prolapse has several types, each varying in severity and presentation. The main types of rectal prolapse include:
- Partial (Mucosal) Prolapse:
- Only the lining (mucosa) of the rectum protrudes from the anus.
- Typically less severe than a full prolapse.
- Protrude a few centimetres from the anal opening, especially during bowel movements.
- Often seen in children and may be associated with cystic fibrosis.
- Full-Thickness Rectal Prolapse:
- Involves the entire wall of the rectum protruding through the anus.
- More severe and noticeable than partial prolapse.
- It can extend several inches outside the body.
- Commonly observed in older adults, particularly women who have had multiple childbirths.
- Internal Prolapse (Intussusception):
- The rectum collapses but does not stick out of the anus.
- The prolapsed rectum folds in on itself (intussusception) but stays inside and can lead to a blockage.
- It can be challenging to diagnose because it’s not visible externally.
- Often requires diagnostic imaging for confirmation.
Complications Associated With Rectal Prolapse
Rectal prolapse, if not properly treated, can result in a range of complications that not only exacerbate physical discomfort but can also significantly impact overall health and quality of life.
- Ulceration and Bleeding: This occurs due to the constant friction between the protruding rectum, clothing, or other external surfaces. Repeated irritation can lead to the formation of ulcers, which are painful and can bleed. This bleeding may not be severe but can be persistent and distressing.
- Impaired Bowel Function: Chronic rectal prolapse can disrupt the normal function of the bowel and manifest in various ways, including chronic constipation or, conversely, faecal incontinence. These issues arise due to the weakening of the muscles and nerves in the rectum, essential for controlling bowel movements.
- Impact on Quality of Life: Beyond the physical symptoms and complications, rectal prolapse can severely affect a person’s quality of life. The visible nature of the condition and symptoms like incontinence can lead to embarrassment, social withdrawal, and psychological distress. The chronic discomfort and the need for lifestyle adjustments can also lead to anxiety and depression, further impacting the individual’s well-being.
Diagnostic Procedures For Rectal Prolapse
If you suspect that you or someone you know is experiencing rectal prolapse, it’s crucial to take appropriate steps to confirm the condition and seek proper treatment. Rectal prolapse is not a condition that should be self-diagnosed or treated at home without professional guidance.
Your doctor needs to perform exams and procedures to advise on the best course of treatment. Diagnosing rectal prolapse involves a combination of clinical assessment and diagnostic tests:
- Physical Examination: A physical examination is the most direct way to diagnose rectal prolapse. This may involve a visual inspection of the anal area, especially during straining or a bowel movement, to observe any protrusion of the rectum.
- Digital Rectal Examination: Your doctor may perform a digital rectal examination (DRE) to assess the tone and strength of the anal sphincter and to check for any abnormalities in the rectum.
- Colonoscopy: In some cases, a colonoscopy may be performed to examine the patient’s colon and rectum from the inside using a flexible tube with a camera. It’s useful for assessing the prolapse and ruling out other conditions like polyps or colorectal cancer.
- Magnetic Resonance Imaging (MRI): An MRI of the pelvis can provide detailed images of the rectum and surrounding structures. It helps in assessing the extent of the prolapse and any associated conditions like a rectocele or enterocele.
- Defecography: This specialised X-ray test shows the rectum and anal canal during a bowel movement. It helps in evaluating how well the rectal muscles are working and how effectively the rectum empties.
- Anorectal Manometry: This test measures how strong the anal sphincter is and how well it’s functioning. It’s especially important if there are symptoms of incontinence.
What Type Of Doctor Treats Rectal Prolapse?
When it comes to treating rectal prolapse, the expertise of a colorectal specialist is typically sought. Colorectal surgeons specialise in conditions that affect the colon, rectum, and anus, making them highly skilled in managing rectal prolapse.
Colorectal specialists are also the ones who perform rectal prolapse surgery and non-surgical treatments, tailoring their approach to the specific needs and health status of each patient.
In addition to colorectal surgeons, gastroenterologists may also be involved in the initial stages. These doctors specialise in the digestive system and can assist in diagnosing rectal prolapse, often conducting initial assessments and recommending further specialised care.
General surgeons might also be involved in certain cases. They can perform various surgical procedures, including those for rectal prolapse, especially in medical settings where specialised colorectal surgeons are not available.
Treatment Options For Rectal Prolapse
The treatment for rectal prolapse depends on the severity of the prolapse, the patient’s overall health, and the presence of any underlying conditions. Treatment options include:
Conservative Management
For mild cases of rectal prolapse or in patients where surgery poses a high risk, conservative management may be recommended. This includes:
- Dietary Changes: Increasing fibre intake to reduce constipation and straining during bowel movements.
- Pelvic Floor Exercises: Exercises such as Kegel and bridges can strengthen the pelvic floor muscles, supporting the rectum and preventing prolapse from worsening.
- Stool Softeners: To ease bowel movements and reduce straining.
- Biofeedback Therapy: Helps improve bowel function and control symptoms.
Rectal Prolapse Surgery
Surgery is often considered when lifestyle changes and non-surgical treatments fail to improve symptoms. The indications for surgery typically depend on the severity of the prolapse, the patient’s overall health, and the impact on their quality of life. Surgical options vary, including:
- Rectopexy: A procedure where the rectum is secured back into its normal position within the pelvis.
- Resection: This involves removing a portion of the rectum and reattaching the remaining parts.
- Perineal Procedures: The Delorme or Altemeier procedures are often used in patients with a higher surgical risk.
- Minimally Invasive Surgery: Laparoscopic and robotic surgeries are becoming increasingly common. These procedures involve smaller incisions, leading to quicker recovery and less postoperative pain.
Each treatment plan is tailored to the individual’s specific circumstances, and a thorough discussion with a colorectal specialist is essential to determine the most appropriate course of action.
It’s important for patients to actively participate in their treatment planning and follow their healthcare provider’s recommendations closely for the best outcomes.
Conclusion About Rectal Prolapse
While rectal prolapse can indeed be a serious and distressing condition, it’s important to remember that with proper management and treatment, the risks can be significantly mitigated.
For expert care, consider consulting a specialist like Dr. QM Leong, an experienced colorectal surgeon well-versed in treating rectal prolapse.
He can guide you through the various treatment options, from conservative management techniques to surgical interventions, ensuring you receive the care. Book a consultation today!
Frequently Asked Questions About Rectal Prolapse
Can You Still Poop With A Rectal Prolapse?
Yes, individuals with rectal prolapse can still have bowel movements. However, the presence of rectal prolapse may affect bowel function. Some individuals may experience changes in bowel habits, such as constipation or incontinence, due to the disruption in the normal anatomy and function of the rectum.
Is Rectal Prolapse Surgery Painful?
While there may be some discomfort and pain after rectal prolapse surgery, healthcare providers typically manage pain with medications. The pain level can vary from person to person and depends on the type of surgery performed.
How Long Is The Recovery Period After Rectal Prolapse Surgery?
Recovery time varies depending on the type of surgery and the individual’s overall health. In general, it may take several weeks to return to normal activities. The surgeon will provide specific guidelines for each case.
Can Rectal Prolapse Recur After Treatment?
Recurrence can occur, especially if underlying risk factors are not addressed. Regular follow-up with the surgeon or specialist and lifestyle modifications can help minimise the risk of recurrence.
