Prolapsed Hemorrhoids With Rectal Prolapse Posted: 07-12-07 01:30am
Rectal prolapse is a condition in which
the rectum falls downwards and turns
inside out. Initially, the rectum stays
inside the body, but as the condition
worsens, it may protrude outside through
the anus. There is often weakness of the
anal muscles, which may result in leakage
of mucus or stool.
Incomplete rectal prolapse involves the
abnormal protrusion of rectal mucosa
through the anus. There is a partial
overlap of this diagnosis with chronic
prolapsed hemorrhoids, especially if part
of the prolapse is hemorrhoids, and part
of the tissue is rectal mucosa. If the
protrusion of rectal mucosa is only
partial, then this is called a partial
mucosal prolapse.
A great majority of patients are
completely relieved of symptoms, or are
significantly helped, by the appropriate
treatment. Rectal prolapse is most often a
chronic condition, and can usually be
reduced with the patient recumbent with
gentle manual pressure. Patients should
minimize their time sitting at commode,
and should be maintained on a suitable
stool softener pending specialty
assessment.
Management of incomplete rectal prolapse
in adults is similar to that of
hemorrhoids. Treatment includes injection
sclerotherapy, mucosal banding, or
surgical restoration and plastic repair of
the anus and rectum. Occasionally anal
sphincter repair is required.
Procidentia in children usually can be
corrected by conservative measures. These
include: a nutritious diet, avoiding
straining at stool, and immediate
replacement of the bowel after each
protrusion to avoid swelling and possible
difficulty in reduction. Children
frequently "outgrow" the disease as the
natural curve of the sacrum becomes more
concave, and surgery may not be needed.
Injections of' sclerosing agents such as
5% phenol in almond oil in the hollow of
the sacrum have helped many patients with
procidentia. These injections, however,
should only be done by a person
experienced in this procedure.
