PROLAPSE OF RECTUM

8*PROLAPSE OF RECTUM**

Definition → Rectal prolapse is a condition where the rectum loses its normal attachment inside the body and drops into the anus.

Types →

1. Partial rectal prolapse → The rectum partially drops into the anus but remains attached to the pelvic floor muscles.
2. Complete rectal prolapse → The rectum fully drops into the anus and loses all attachment to the pelvic floor muscles.

Causes →

1. Constipation
2. Straining during bowel movements
3. Weakness in the muscles that support the rectum
4. Damage to the rectal tissue
5. Neurological disorders
6. Trauma to the rectal area
7. Previous surgeries
8. Aging
9. Chronic conditions like Parkinson's disease, multiple sclerosis, or muscular dystrophy

Clinical Features →

1. Discomfort or pain during bowel movements
2. Feeling of incomplete evacuation
3. Leaking of stool or gas
4. Bowel obstruction
5. Abdominal pain or cramping
6. Rectal bleeding
7. Fecal incontinence
8. Feeling of a mass or lump in the rectum

Investigations →

1. Digital rectal examination
2. Endoscopy
3. Barium enema
4. CT scan or MRI
5. Colonoscopy
6. Anorectal manometry
7. Defecography

Complications →

1. Fecal incontinence
2. Bowel obstruction
3. Rectal bleeding
4. Infection
5. Perforation of the rectum
6. Chronic constipation or diarrhea
7. Stricture or narrowing of the rectum

Non-Surgical Management →

1. Dietary changes → Increase fiber intake to improve bowel regularity
2. Lifestyle modifications → Regular exercise, bowel habits, and stress management
3. Medical management → Medications to manage symptoms, constipation, or fecal incontinence
4. Biofeedback therapy → Training to improve bowel control and regularity
5. Pelvic floor exercises → Strengthening of the muscles that support the rectum

Surgical Management →

1. Rectopexy → Attaching the rectum to the sacrum using mesh or sutures
2. Rectal prolapse repair → Repairing the damaged rectal tissue and attaching it to the pelvic floor muscles
3. Abdominal perineal resection → Removing the rectum and part of the anus
4. Alloplastic repair → Using a prosthetic material to support the rectum
5. Laparoscopic or robotic-assisted surgery → Minimally invasive procedures to repair the rectum

Homoeopathic Therapeutic Medicines →

1. Nux vomica → For constipation and straining during bowel movements
2. Opium → For diarrhea and rectal irritation
3. Aloe socotrina → For rectal irritation and inflammation
4. Calcarea carbonica → For rectal prolapse and constipation
5. Graphites → For rectal prolapse and anal fissures