Rectal Prolapse | Don't be shy about talking about this!

Do you sometimes feel like there's something heavy or like a ball coming out of your rectum when you go to the toilet? We know this is a really embarrassing and embarrassing thing to talk about. But this is not just a problem for you, it's a medical condition that can affect many people. So don't be afraid or embarrassed about it. Today we're talking about rectal prolapse, or what's medically called `(Rectal Prolapse)`.

Simply put, what is rectal prolapse?

Okay, to understand this, let's first learn a little about this part of our body. The last part of your large intestine is what we call the `rectum` or the last part of the rectum. It is located just above your anus. After the food we eat is digested, the remaining waste, called feces, temporarily accumulates in this part called the `rectum`. When this part is full, we feel the need to go to the toilet. Then, the muscles around it contract to push the feces out through the anus.

Now, in a `Rectal Prolapse`, as soon as the stool comes out, the last part of the rectum that was holding it also comes out. Like a telescope going in, this part slips in and comes out of the anus. Sometimes it can come out just a little, other times it can come out completely.

"Prolapse" is a word used by doctors. It means that an organ in the body falls down from its normal position. This usually happens when the muscles that hold the organ in place weaken.

Who is most likely to develop this condition? What are the causes?

Although this condition can occur at any age, it is most common in women over the age of 50. In addition, it can sometimes occur in young children. It is caused by long-term diarrhea or diseases such as ``Cystic Fibrosis``.

It is difficult to pinpoint the exact cause of this, but several factors may contribute to it. The main one is the weakening of the muscles that hold the rectum in place. Factors that contribute to this include:

• Aging: Like all muscles in the body, this one also weakens a little as we age.
• Pregnancy and childbirth: Giving birth puts a lot of pressure on the muscles of the pelvis, which can weaken them.
• Long-term constipation or diarrhea: Constant straining to pass stool on the toilet can damage these muscles. This condition can also occur even if you have ongoing diarrhea.
• Previous surgeries or injuries to the pelvic cavity or surrounding area.
• Intestinal parasitic infections.
• Long-term coughing or sneezing: This condition can also be caused by pressure on the abdomen caused by frequent coughing due to medical conditions like asthma.
• Damage to the spinal cord or nerves.
• Genetic conditions such as Cystic Fibrosis.

Is this hemorrhoids? Or is it something else? How do I know for sure?

This is the biggest problem that many people have. Many people confuse this condition with hemorrhoids. It is normal to think so because the symptoms of both conditions are similar. Hemorrhoids are swollen blood vessels around the anus. They can also cause pain, itching, and bleeding. Sometimes hemorrhoids can also come out.

But there are clear differences between the two. Let's look at this table to give you a better understanding.

How does a doctor find this?

When you go to see a doctor, he will first ask you about your symptoms. Then he will do a physical examination. During this, he may ask you to try to defecate, to see if your rectum comes out at that time.

Sometimes, you may be referred for further tests to confirm the condition or to see if there are other problems.

• Digital Rectal Exam: The doctor examines the rectum using a gloved finger.
• Defecography: A test that takes X-ray or MRI images of your muscles while you defecate.
• Anorectal Manometry: A test that measures the strength of the muscles (sphincters) around the anus.
• Colonoscopy: Examination of the inside of the large intestine using a tube with a camera attached.
• Electromyography (EMG): This tests muscle function to see if there is nerve damage.

What happens if left untreated?

This is not an emergency or life-threatening condition. However, if left untreated, it can gradually worsen over time. It can also cause increased discomfort and various complications.

In the early stages, once the anus is out, it can be pushed back in. Doctors advise turning on your side, bringing your knees to your chest, and gently pushing it back in with a damp cloth. But this is only a temporary solution.

The main complications that can occur if left untreated are:

• Fecal incontinence: This is a condition in which the muscles in your rectum continue to contract, causing you to lose stool or gas without even realizing it. This condition affects 50% to 75% of people.
• Constipation: A blockage in the rectum can make it difficult to pass stool properly.
• Rectal Ulcers: Frequent rubbing of the rectum can cause the area to bleed and become sore. If the bleeding continues, it can even lead to anemia.
• Incarceration and Strangulation: This is the most dangerous complication. The rectum can become stuck and unable to be pushed back in. If this happens, the blood supply to that area can be cut off and the tissue can die. We call this ``Gangrene``. This is a condition that requires emergency medical treatment.

What are the solutions to this? (Let's learn about surgery)

When an adult develops this condition, it does not heal on its own. The only permanent solution is surgery. In young children, it may resolve on its own once the underlying cause, such as constipation, is treated.

There are several types of surgery. Your surgeon will choose the most suitable method for you based on the nature of your condition, age, and overall health. There are two main types of surgery.

1. Abdominal Approach - Rectopexy

This is the most common and successful procedure. The surgeon makes an incision in the abdomen (open surgery) or inserts a camera through several holes (laparoscopic surgery), lifts the prolapsed rectum back up, places it on the back wall of the pelvis, and secures it with permanent stitches or a mesh. This procedure has a success rate of about 97%. If you also have chronic constipation, your doctor may decide to remove a small part of your colon during this surgery.

2. Surgery through the anus (Perineal Approach)

This method is best for people who cannot undergo major surgery through the abdomen, are elderly, or have other medical conditions. In this method, the surgery is performed through the anus. Since there are no large incisions in this method, recovery is faster. However, there is a slightly higher chance of the condition recurring after this method.

What can be done to prevent this situation and stop it from recurring?

There are several things you can do to prevent this condition from occurring and to stop it from recurring after surgery.

• Control constipation and diarrhea: If you have persistent constipation or diarrhea, be sure to see a doctor and get it treated. Eat fiber-rich foods (fruits, vegetables, legumes) and drink plenty of water.
• Strengthen your pelvic floor muscles: You can strengthen these muscles by doing Kegel exercises. Ask your doctor or physical therapist about how to do these exercises.
• Be careful when lifting weights: Use proper posture when lifting heavy weights.

Prolapse is a condition that occurs gradually due to muscle weakness. It doesn't happen overnight. So, without feeling ashamed or afraid about it, the best thing you can do is to seek medical advice as soon as possible.

Rectal prolapse, hemorrhoids, constipation, anus, surgery, women's health