Rectum starts from the last portion of the large intestine and is about 12 cm in length. Due to the weakness of the structures supporting rectum, it may sometimes bulge through the anus. Sometimes this prolapse may not be visible externally. Bleeding, pain, mucus drainage and obstruction to defecation are the commonly experienced symptoms.
Generally there are three kinds of rectal prolapse. They are external, circumferential and full thickness. When the prolapse is externally visible it is known as external and when the entire circumferential area is involved in the prolapse it is known as circumferential prolapse and when the all the layers of of the walls of the rectum is involved it is known as full thickness rectal prolapse.
A lump outside the back passage is the most common symptom. Initially it will be seen only during the bowel openings. But later it may be seen when you are coughing or even when you are walking or standing. Initially it can be pulled back to its normal position and slowly it becomes difficult to pull back the protrusion to its original place. At this stage it becomes highly essential to meet a physician and try for appropriate remedies as further deterioration can be dangerous.
Usually diagnosis is made in a routine examination based on the symptoms and the findings in the physical examination.A special X-ray called evacuation proctogram will be useful for assessing the exact size and other details about the prolapsed rectum.
Medical treatment for prolapsed disc is aims at improving the symptoms and preventing the prolapse to get worse. For this purpose a diet with more fiber content will be suggested by the physician. This will help the opening of the bowel. Laxatives like fybogel may also be prescribed for the patient which will make the stool softer.
Surgical procedure for prolapsed rectum, is known as mesh rectoplexy. This is usually done as a laparoscopic procedure carried out under general anesthesia.The surgeon makes an opening of the size 1 to 2 inches on the abdomen of the patient and through this incision a laparoscope which is an instrument with a camera on one end of a long tube is inserted. The other end of the tube is connected to a monitor placed before the surgeon. With the help of this camera the surgeon will be able to view the enlarged videos of the organs to be operated and the entire surgery in the monitor. By seeing these videos and remotely controlling the special instruments inserted into the body through other small incisions in the body, the surgeon carries out the surgery.
As the surgery begins the surgeon clears the rectum from its connections to the body and makes it free. After this the rectum is placed in its proper position and synthetic meshes are placed to give support to it so that it will not again prolapse. After completing the procedure the rectum is stitched to fix the rectum in its new position and to avoid further protrusion. If necessary the surgeon removes a small piece of sigmoid colon for making space for the rectum to be positioned correctly.After completing the surgery the pelvic area is rinsed well and the incisions are stitched.
After the surgery
After the surgery you will be asked to walk a little distance every day as walking is the best exercise for better recovery and for returning to normal life. You will be required to be under soft diet till your next scheduled meeting with the surgeon. If any complications arise in between you should inform it immediately to the surgeon and act as he directs.