Rectal prolapse

Rectal prolapse is a disease in which the rectum turns out through the anus to the outside. Distinguish mucosal prolapse and complete loss of all layers of the rectum wall.

Etiology. Intestinal peristalsis with diarrhea, increased intra-abdominal pressure with physical tension and constipation, weakened elasticity, tonus, traumatic and dystrophic lesions of the musculo-aponeurotic formations of the pelvic diaphragm and ligamentous apparatus of the rectum.

Symptoms, course. In children with dyspepsia or constipation during the act of defecation, a large part of the rectum can immediately drop out, and then the cylinder of the colon that has fallen out is clearly visible, covered with a mucous membrane. Repeated fallout during defecation can turn into habitual and remain in the adult state. In children, rectifying the bowel and eliminating the causative factors (diarrhea or constipation) can lead to a cure. In adults, loss is prone to progression only, accompanied by a sensation of the foreign body in the anus, pain, mucus and blood secretion as a result of irritation and trauma of the mucous membrane of the fallen intestine, incontinence of gases and feces (increasing weakness of the sphincter). Rectal prolapse in adults often develops gradually, beginning with the prolapse of only the mucous membrane of the rectum, and then becomes complete. The loss of a significant part of the rectum and sigmoid colon may be accompanied by a violation of blood circulation and necrosis of the intestinal wall.

The diagnosis does not present difficulties when examining the area of ​​the anus, especially when straining in the patient's squatting position. The degree of insufficiency of the sphincter accompanying prolapse of the rectum, is determined by finger examination through the anus and by sphincterometry.

Treatment in children is predominantly conservative - the control of the fallen intestine in the prone position with raised legs. After that, appoint a bed rest for 1 -3 days. Emptying of the intestine during this period should occur in a prone position. In adults, in the absence of spontaneous correction after the act of bowel movement, a knee-elbow position with a lowered head is recommended, combined with deep breathing. At the same time, a slight finger allowance is possible after lubrication with petroleum jelly. With the progression of the disease and in adults, the treatment is surgical.

The prognosis in most children is favorable. In adults, there is a tendency to relapse, even after surgical correction.