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Rectal Prolapse Treatment

Rectal Prolapse Treatment - Diagnosis, Surgery & Recovery at Curific Health Care

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    What is Rectal Prolapse?

    The rectum, located at the end of the large intestine, is the part of the digestive system that holds stool before it is passed out of the body. Normally, muscles push the stool out through the anus during defecation. However, in the case of rectal prolapse, the rectum itself slips out of its original position and protrudes through the anus.

    The term ‘prolapse’ refers to any organ shifting from its normal position.

    Who is at Risk?

    Rectal prolapse is more common in:

    • Women (higher incidence than men)
    • Individuals aged 50 and older
    • People with a history of:
      • Chronic constipation
      • Chronic diarrhoea

    If left untreated, rectal prolapse can lead to complications and significantly impact quality of life.

    For advanced and effective treatments, consult a qualified proctologist today!

    Rectal Prolapse Diagnosis

    The complete diagnostic procedure for rectal prolapse includes:

    Physical Examination: In the physical examination, the doctor observes the rectum and may insert a gloved and lubricated finger in the anus to check the strength of the anal sphincter and the rectum. In this exam, the doctor will ask you to describe your symptoms and medical history to understand the condition better. They may even ask you to squat and strain as you do during the bowel movement. 

    Based on the findings of the physical assessment, the doctor might ask you to get some other tests done. 

    • Anal electromyography (EMG): This test lets doctors measure the effectiveness of muscles and nerves in the rectum. The doctors place electrodes a few inches into the rectum to perform this test. The procedure takes a few minutes. 
    • Colonoscopy: This diagnostic procedure involves the insertion of a thin and flexible tube with a small camera (colonoscope) into the rectum to perform a visual exam of the area. 
    • Anorectal manometry: In this test, doctors use a flexible tube which is the size of a thermometer and has a small deflated balloon attached to its end to measure the rectum’s response to pressure. The device is inserted into the rectum before conducting the test. 
    • Barium enema: In the Barium Enema test, the doctors place a chalky liquid containing barium in the rectum of the patient. The barium becomes visible on the X-rays, producing clear images of the area. 
    • Defecography: In this test, the doctors use x-rays or MRIs to monitor your colon as you have a bowel movement. 
    • Lower GI series: To perform this test, doctors place a chalky liquid containing barium in the large intestine of the patient. This liquid lets doctors get a clear picture of the area on an x-ray. 
    • Transit study: In this test, the doctor asks the patient to swallow one or more capsules which have markers on them. These markers can be seen on the X-ray. After swallowing the capsules, the patient has to appear for x-rays for the next 5 days. It helps doctors assess how the markers pass through the intestines. 

    In some cases, the doctor might suggest some urological or gynaecological exams to check for weak areas in the pelvic floor and see if other organs, such as the uterus, have prolapsed as well. 

    Surgical Treatment for Rectal Prolapse

    There are various surgical treatment options for rectal prolapse, including:

    Rectopexy for Rectal Prolapse Surgery Through The Abdomen
    Rectopexy, also known as rectal prolapse surgery through the abdomen, is typically performed under general anesthesia and may require a hospital stay of several days. Recovery time varies, but most patients are able to return to normal activities within a few weeks. Rectopexy is considered a safe and effective treatment for rectal prolapse and has a high success rate in preventing recurrence. Here’s how the procedure is performed:

    1. The surgeon will make an incision in the abdomen.
    2. The rectum is located and carefully dissected from the surrounding tissues.
    3. The rectum is sutured to the sacrum, ensuring proper positioning.
    4. The abdominal incision is then closed with sutures or staples.
    5. The patient is monitored closely post-procedure for proper healing.

    Laparoscopic Rectal Prolapse Surgery
    Laparoscopic rectal prolapse surgery is a minimally invasive procedure performed through small incisions in the abdomen, rather than a large incision. Benefits include less pain, faster recovery, and lower risk of complications. Patients typically return to normal activities within a few weeks. Here’s how the procedure works:

    1. General anesthesia is administered to the patient.
    2. A laparoscope is inserted into the abdomen.
    3. Small incisions are made to insert surgical instruments.
    4. The rectum is located and gently pulled out.
    5. Any excess tissue or prolapsed areas are removed.
    6. The rectum is sutured back into place.
    7. The incisions are closed with sutures or staples.
    8. The patient is monitored in the recovery room before discharge.

    Robotic Surgery for Rectal Prolapse
    Robotic surgery is a minimally invasive technique offering several benefits over traditional open surgery, including reduced blood loss, less pain, and shorter recovery times. The procedure includes:

    1. Small incisions are made in the abdomen.
    2. Robotic arms are inserted through the incisions.
    3. The surgeon controls the robotic arms from a console.
    4. The robot creates a 3D image of the surgical site.
    5. The surgeon uses the robotic arms to remove any excess tissue causing the prolapse.
    6. Sutures are used to secure the rectum in its proper position.
    7. The robotic arms are removed, and the incisions are closed.
    8. The patient is monitored for complications and provided with pain management.

    Perineal Rectosigmoidectomy
    Perineal Rectosigmoidectomy removes part of the rectum and sigmoid colon via the perineum. This procedure offers faster recovery and a lower risk of complications. The process includes:

    1. The surgeon makes an incision in the perineum.
    2. The rectum is dissected and mobilized.
    3. A suture line is created at the distal rectum.
    4. The redundant tissue is removed.
    5. A colostomy may be created if needed.
    6. The perineal incision is closed.
    7. The patient is closely monitored post-procedure.

    Delorme Procedure
    The Delorme procedure involves folding and sewing a portion of the rectal wall to itself to reinforce weak or damaged tissue. This method improves bowel function and reduces the risk of recurrence. Recovery generally takes 2-4 weeks. The steps are:

    1. Anesthesia is administered to the patient.
    2. A proctoscope is inserted into the rectum to visualize the prolapse.
    3. The prolapsed tissue is removed using a scalpel or scissors.
    4. The remaining rectal tissue edges are sutured together.
    5. The area is checked for bleeding or damage.
    6. The patient is moved to the recovery room once complete.

    What are the Benefits of Laser Rectal Prolapse Surgery?

    Laser rectal prolapse surgery offers various advantages, including:

    • Minimally Invasive: This procedure involves minimal or no incisions, leading to faster recovery.
    • Outpatient Procedure: Laser surgery can often be performed on an outpatient basis, reducing hospital stays.
    • Lesser Pain: Patients typically experience less pain and a quicker recovery than with traditional surgery.
    • Precise: Laser technology allows for greater precision, reducing complications and improving outcomes.
    • Low Risk of Infection: The reduced need for cuts or incisions lowers the chances of infection and bleeding.
    • Reduced Incontinence: Many patients experience improved bowel function and reduced incontinence.
    • Effective Treatment: Laser surgery is particularly useful for patients who haven’t responded to other treatments.
    • Improved Quality of Life: Beyond physical health, patients often report a significant improvement in their quality of life after surgery.

    Overall, laser rectal prolapse surgery is a safe and effective option for patients seeking relief from rectal prolapse symptoms.

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      Rectal Prolapse Treatment at Curific Health Care

      Preparing for Rectal Prolapse Surgery

      If your doctor has recommended rectal prolapse surgery, it’s essential to be well-prepared. Here are some tips to help you get ready for the procedure:

      1. Consult Your Doctor: Speak with your healthcare provider to understand the procedure and any potential risks.
      2. Follow Pre-Op Instructions: Adhere to the pre-operative guidelines given by your medical team.
      3. Arrange Transportation: Ensure you have someone to drive you to and from the hospital on the day of the surgery.
      4. Post-Surgery Assistance: Arrange for a helper to stay with you in the initial days after surgery to assist with daily activities.
      5. Fasting Instructions: Avoid eating or drinking anything after midnight the night before surgery.
      6. Medications and Supplements: Stop taking blood thinners like ibuprofen, warfarin, or herbal supplements as they could increase the risk of bleeding.
      7. Wear Comfortable Clothing: Choose easy-to-remove clothing for the day of surgery.
      8. Prepare Your Home: Set up a cozy area with pillows, blankets, and entertainment for your recovery period.
      9. Follow Additional Instructions: Adhere to any other specific instructions from your healthcare team to ensure a smooth surgery and recovery process.

      Recovering After Laser Rectal Prolapse Surgery

      Recovery from laser rectal prolapse surgery can take anywhere from 4 to 6 weeks. Here are some general tips to help you recover quickly:

      1. Medication Adherence: Take prescribed medications on time as directed by your doctor.
      2. Managing Discomfort: Swelling and discomfort at the surgical site are common and can be alleviated with ice packs and prescribed pain relievers.
      3. Avoid Heavy Lifting: Refrain from lifting heavy objects and engaging in strenuous activities for several weeks to allow proper healing.
      4. Dietary Considerations: Follow a high-fiber diet to prevent constipation and avoid straining during bowel movements.
      5. Hydration: Drink plenty of water to stay hydrated and support digestive health.
      6. Stool Softeners: Your doctor may suggest using stool softeners or laxatives to make bowel movements more comfortable.
      7. Follow-Up Appointments: Attend all scheduled follow-up visits with your doctor to monitor your healing process.
      8. Watch for Warning Signs: If you experience severe pain, fever, or unusual symptoms, contact your doctor immediately.

      Lifestyle Changes After Rectal Prolapse Surgery

      Making certain lifestyle changes after rectal prolapse surgery can help prevent a recurrence and promote proper healing. Here are some key changes to consider:

      1. Avoid Heavy Lifting: Refrain from lifting heavy objects for at least six weeks post-surgery to avoid stress on the pelvic muscles.
      2. High-Fiber Diet: Incorporate fiber-rich foods like fruits, vegetables, whole grains, and legumes into your diet to prevent constipation.
      3. Stay Hydrated: Drinking enough water will help keep your stools soft and make bowel movements easier.
      4. Exercise Regularly: Engaging in regular physical activity can strengthen your pelvic muscles and improve overall health, lowering the risk of recurrence.
      5. Avoid Straining: Avoid straining during bowel movements as it can put pressure on the rectum. Respond to the urge to use the restroom as soon as it arises.
      6. Maintain a Healthy Weight: Keeping a healthy weight through balanced eating and exercise reduces pressure on the pelvic area and lowers the risk of prolapse.

      By making these adjustments to your lifestyle, you can promote a smoother recovery and reduce the likelihood of rectal prolapse returning in the future. Always follow your healthcare provider’s recommendations for the best results.

      What are the Risks and Complications Associated with Rectal Prolapse Surgery?

      While rectal prolapse surgery is an effective treatment option, it does come with potential risks and complications. These include:

      • Infection: An infection at the surgical site is a possible risk after surgery.
      • Hemorrhage: Excessive bleeding during or after the procedure can occur.
      • Damage to Nearby Organs: There’s a chance that nearby organs such as the bladder or urethra could be damaged during surgery.
      • Urinary Retention: Some patients may experience difficulty urinating after the surgery.
      • Blood Clots: The formation of blood clots is a risk post-surgery.
      • Bowel Obstruction: Though rare, bowel obstruction can occur as a complication.
      • Fecal Incontinence: Some patients may experience difficulty controlling bowel movements after the surgery.
      • Recurrence of Rectal Prolapse: The condition may return after surgery.
      • Anesthesia-Related Complications: Anesthesia poses risks, including adverse reactions during the procedure.
      • Complications Increase with Age and Other Conditions: The risk of complications is higher for older patients or those with underlying health issues.

      What are the Non-Surgical Treatment Options for Rectal Prolapse?

      If you’re experiencing rectal prolapse but surgery is not recommended, there are several non-surgical treatment options that may help alleviate symptoms or prevent worsening of the condition. These include:

      • Home Remedies:
        • Kegel Exercises: Strengthening pelvic floor muscles through exercises may help prevent prolapse.
        • Fiber-Rich Diet: A diet high in fiber, including whole grains, fruits, and vegetables, can help prevent constipation and strain, a common contributor to prolapse.
        • Bowel Movement Management: Avoiding long delays in responding to bowel urges can help prevent prolapse.
        • Ice Packs: Applying ice to the affected area may reduce swelling and discomfort.
        • Staying Hydrated: Drinking sufficient water can help keep stools soft and reduce strain during bowel movements.
        These remedies are useful in symptom management but should not replace medical treatment. Always consult with a proctologist to determine the best course of action for your specific condition.

      What Are the Risks and Complications Associated with Anal Fissure Surgery?

      While anal fissure surgery is generally safe, certain risks and complications may arise:

      • Infection: Post-surgery infections can occur but are preventable with proper hygiene and aftercare.
      • Bleeding: Some bleeding is common; avoiding blood-thinning medications before surgery reduces this risk.
      • Pain: Discomfort or pain is expected post-surgery, manageable with prescribed pain relievers.
      • Incontinence: Rarely, the surgery may affect bowel control, leading to temporary or permanent incontinence.
      • Anal Stenosis: A narrowing of the anal passage, which can make bowel movements difficult, might occur in rare instances.
      • Abscess Formation: Occasionally, abscesses may develop, requiring additional treatment.
      • Allergic Reactions: Some individuals might experience an allergic reaction to anesthesia or medication used during the procedure.
      • Nerve Damage: Rare nerve-related complications can lead to numbness or tingling in the anal area.
      • Recurrence: Although surgery is effective, anal fissures can reappear, necessitating further treatment.

      Lifestyle Changes After Anal Fissure Surgery

      To ensure smooth recovery and prevent recurrence, the following lifestyle changes are recommended:

      • High-Fiber Diet: Incorporate fiber-rich foods to soften stools and avoid straining during bowel movements.
      • Hydration: Drink adequate water daily to prevent constipation.
      • Avoid Prolonged Sitting: Minimize pressure on the rectal area by taking regular breaks and walking.
      • Limit Strenuous Activity: Avoid heavy lifting and vigorous exercise for 4–6 weeks post-surgery.
      • Sitz Baths: Use warm water baths to alleviate pain and reduce swelling.
      • Maintain Hygiene: Keep the anal area clean and dry to prevent infections.
      • Avoid Irritants: Limit spicy or acidic foods that could irritate the anal region.
      • Follow Prescriptions: Take pain medications or other prescribed treatments as directed.
      • Monitor Recovery: Attend follow-up appointments to track healing progress and address any issues.

      By adhering to these recommendations, patients can enhance their recovery and reduce the chances of complications or recurrence.

      What are the Signs of a Healing Rectal Prolapse?

      The following signs may indicate that your rectal prolapse is healing:

      • Reduced Size: The prolapsed tissue appears smaller, indicating healing.
      • Less Recurrence: A decrease in the frequency of prolapse episodes.
      • Improved Bowel Movements: Reduction in constipation and easier bowel movements.
      • Less Pain and Discomfort: A decrease in the severity of pain and discomfort.
      • Reduced Bleeding: Less bleeding from the rectum.
      • Decreased Mucus Discharge: A reduction in the amount of mucus coming from the rectum.
      • Reversed Bowel Incontinence: Improved control over bowel movements.
      • Less Swelling: A reduction in swelling or inflammation around the rectum.
      • Less Protrusion: A decrease in the amount of tissue protruding from the anus.

      What Happens if Rectal Prolapse is Left Untreated?

      If left untreated, rectal prolapse can lead to serious complications, including:

      • Worsening of the Condition: The prolapsed rectum can become larger and more difficult to push back in.
      • Chronic Constipation: Increased pressure from constipation can worsen prolapse.
      • Fecal Incontinence: Loss of control over bowel movements may occur.
      • Irritation and Bleeding: The prolapsed tissue can become irritated, leading to bleeding.
      • Incarceration or Strangulation: In severe cases, the prolapsed tissue may become trapped, cutting off blood flow and leading to tissue death, requiring emergency surgery.
      • Psychological Distress: The condition can cause emotional and psychological stress, negatively affecting quality of life.

      What Foods Should You Eat If You Have A Rectal Prolapse?

      To help manage symptoms of rectal prolapse and avoid aggravating the condition, consider including the following foods in your diet:

      • Fiber-Rich Foods: Fruits, vegetables, whole grains, and legumes provide essential fiber to prevent constipation.
      • Insoluble Fiber: Foods like bran and beans are excellent for bulking up stools and preventing straining.
      • Hydration: Drinking plenty of water helps keep stools soft.
      • Probiotic Foods: Yogurt and kefir can promote healthy gut bacteria and reduce inflammation.
      • Lean Proteins: Chicken, fish, and tofu provide essential nutrients without adding excess fat.
      • Low-Fat Dairy: Milk and cheese are good sources of protein and calcium without causing constipation.

      What Foods Should You Avoid If You Have A Rectal Prolapse?

      Certain foods should be avoided to prevent worsening of rectal prolapse symptoms. These include:

      • Spicy Foods: Can irritate the digestive system and cause discomfort.
      • Processed Foods: High in sodium, processed foods can contribute to constipation.
      • Fried Foods: High-fat, hard-to-digest foods that may worsen symptoms.
      • Dairy Products: Dairy can be constipating for some people and should be consumed in moderation.
      • Red Meat: Difficult to digest and can lead to constipation.
      • Caffeine: Can be dehydrating and contribute to constipation.
      • Alcohol: Also dehydrating and can worsen symptoms.
      • Carbonated Beverages: Can cause bloating and discomfort.
      • Spicy Condiments: Hot sauces and chili can irritate the digestive system.
      • Excessive Fiber: While fiber is beneficial, too much can lead to bloating and constipation, which may exacerbate prolapse symptoms.

      Adhering to a balanced diet, rich in fiber and water while avoiding certain irritants, can help manage rectal prolapse symptoms and promote healing. Always consult with your healthcare provider or a dietitian for a personalized dietary plan.

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