Part or all of the rectal wall shifts downwards, which is called rectal prolapse, commonly known as rectal prolapse. Part of the rectal wall moves down, that is, the rectal mucosa moves down, which is called mucosal prolapse or incomplete prolapse; the full-thickness of the rectal wall moves down is called complete prolapse. If the rectal wall moves down inside the anorectal cavity, it is called internal prolapse; if it moves down outside the anus, it is called external prolapse. Rectal prolapse mostly occurs in children and middle-aged women. Rectal prolapse in children is mostly mucosal prolapse, which usually heals spontaneously before 5 years old. Adult complete rectal prolapse is rare. For example, repeated rectal prolapse can cause pudendal nerve damage and anal incontinence, and may cause rectal ulcers, bleeding, stenosis, and necrosis, requiring surgical treatment.
The cause of rectal prolapse (rectal prolapse) is not fully understood, and it is believed to be related to many factors.
1. Anatomical factors
Stunted infants, malnourished patients, and the elderly are prone to weakness and weakness of the levator ani muscle and pelvic floor fascia; the sacrum is small and straight in children; factors such as surgery, trauma, and peripheral anorectal muscles or nerves can be weakened The fixation and support of the tissues around the rectum make the rectum easy to prolapse.
2. Increased abdominal pressure
Such as constipation, diarrhea, enlarged prostate, chronic cough, dysuria, multiple childbirths, etc., often cause the abdominal pressure to rise and push the rectum downward to prolapse.
Internal hemorrhoids and rectal polyps often prolapse, and the rectal mucosa is pulled downward to induce mucosal prolapse.
What are the symptoms of prolapse?
The main symptom is prolapse of a mass from the anus. The tumor was small when it first appeared, prolapsed during defecation, and reset itself after defecation. Afterwards, the masses gradually prolapse and increase in volume, and they need to be returned to the anus with hands after defecation, accompanied by a feeling of incomplete defecation and falling. Finally, it can come out when coughing, straining or even standing. As the prolapse worsens, different degrees of anal incontinence are caused, and mucus often flows out, leading to eczema and itching of the perianal skin. Due to difficulty in emptying the rectum, constipation often occurs, and stools increase frequently, which looks like sheep feces. The mucous membrane is eroded and blood flows out after ulceration.
How to distinguish anal prolapse and internal hemorrhoids?
1. Blood in the stool
The early stage of internal hemorrhoids is mostly painless blood in the stool, sometimes dripping blood, sometimes spurting blood or sticking blood on the toilet paper; and the main symptoms of prolapse of the anus are prolapse of the anal canal and mucous membrane, and blood in the stool is rare.
The internal hemorrhoids are generally painless in the early stage, and severe pain is unbearable after incarceration in the later stage; and prolapse of the anus is sometimes accompanied by severe pain.
Internal hemorrhoids often have symptoms such as wet anus, while prolapsed anus often has mucus overflowing from the anus. The two symptoms are similar.
The prolapse of internal hemorrhoids is the hemorrhoids, usually hemorrhoids do not prolapse in stage I, and hemorrhoids prolapse only in stages II and III, and sometimes incarceration occurs in the late stage; and the rectal mucosa, anal canal and rectum are prolapsed in the late stage. It can reach more than ten centimeters.