Rectal Prolapse


What is rectal prolapse?

Rectal prolapse occurs when the lower part of the gut called rectum protrudes out of the anus. This mostly occurs when the sphincter that controls the bowel movement becomes weak. This sphincter is made of muscles. When these sphincter muscles become weak, they no longer work efficiently and may lead to leakage of mucus and stool.

What causes rectal prolapse?

Rectal prolapse results from weakened sphincter. In many patients, this comes as part of an aging process. As we get older the ligaments and muscles become more lax and weak. Rectal prolapsed can also happen due to a number of other reasons including trauma during delivery, chronic straining while bowel movement, pelvic floor dysfunction, neurological conditions such as spinal cord disease. In rare occasions, a familial component may play a role in developing this condition.

How is rectal prolapsed diagnosed?

Rectal prolapse is diagnosed on physical exam. Also electronic POP –q device which is patented and developed by Dr. Shakiba at Women’s Pelvic surgery of North Jersey, at Hackensack NJ is the newest innovation for the accurate measurement of the degree of rectal prolapse and other type of pelvic organ prolapse. In patients where rectal prolapse is not visible, defecogram studying can be done. Defecogram is a radiologic imaging study that involves taking X-Ray pictures while the patient is having a bowel movement. Anorectal manometry is also a useful study to assess the function of the anal sphincter. Anorectal manometry is a study that assesses the muscle tone of the sphincter and muscles in rectum and anus.

How is rectal prolapse treated?

There are multiple ways of treating rectal prolapse. Pessary and physical therapy, along with lifestyle modification, weight loss, correction of constipation, are the first steps for the management and treatment of rectal prolapse. If conservative management failed to alleviate the patient discomfort, surgery will come to play an important role. Abdominal or rectal surgery is done to correct this problem. The choice of the procedure is based on factors like patient’s age, physical fitness, and severity of the prolapse. This surgical treatment is pretty successful. Most patients completely overcome this condition. The effectiveness of the procedure is based on severity and location of the prolapse and overall health of the patient. Also medical condition such as Obesity, diabetes, chronic constipation, chronic lung disease and cough, smoking, among others may affect the outcome of the surgery. Dr. Shakiba is board certified in Female Pelvic Medicine and Pelvic Reconstructive Surgery (FPMRS), and he will choose the best treatment matched with your condition and the degree of the rectal prolapse.

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