What is anal prolapse?

Rectal prolapse, which we usually call rectal prolapse, is common in the elderly and children. The cause of this problem is closely related to long-term constipation, diarrhea, chronic coughing, urination, and difficulty in urination caused by increased intra-abdominal pressure.

1. Intestinal prolapse refers to a pathological condition in which the anal canal , rectum, or even the lower end of the sigmoid colon shifts downward and protrudes outside the anus. Only submucosal prolapse is incomplete prolapse, while prolapse of the entire rectum is complete prolapse. The prolapsed part located in the rectum is called internal prolapse, and prolapse outside the anus is called external prolapse. The main symptom is a mass protruding from the anus. The swelling is small at first, falls out during bowel movements, and repositions itself after bowel movements. Later, the tumor prolapsed more frequently and increased in size, and needed to be pushed back into the anus by hand after defecation, accompanied by an incomplete bowel movement and a feeling of falling. Finally, it can be removed by coughing, exerting force or even standing.

Rectal prolapse is more common in children and the elderly. Rectal prolapse is a self-limiting disease in children, and most of them heal themselves before the age of 5. Therefore, non-surgical treatment is the main treatment. For adults with complete rectal prolapse, if the disease is more serious, long-term prolapse will cause pudendal nerve damage, anal incontinence, ulcers, perianal infection, rectal bleeding, edema, necrosis and stenosis of the prolapsed intestinal segment, and surgical treatment should be the main treatment.

2. Reasons

1. Anatomical factors

The curvature of the sacrum and coccyx in children is small, and the rectum is more vertical. When the intra-abdominal pressure increases, the rectum lacks support and is prone to prolapse. The peritoneum of the rectal fossa is reflected too low, and the increased intra-abdominal pressure and intestinal loops cause the anterior wall of the rectum to protrude into the rectal ampulla, leading to prolapse. Muscle relaxation in the elderly, excessive childbirth or perineal tears during delivery can also cause rectal prolapse.

2. Increased intra-abdominal pressure

Long-term constipation, diarrhea, chronic cough and difficulty urinating can cause increased intra-abdominal pressure and lead to rectal prolapse. Foreign studies in recent years have found that rectal prolapse is often accompanied by mental or nervous system diseases. The relationship between the two is still unclear. Some people believe that when the nervous system is diseased, the function of controlling and regulating defecation is impaired, the rectum is chronically dilated, and the sensitivity to fecal stimulation is reduced, resulting in constipation and decreased ability to control defecation. Abnormal force during defecation weakens the function of the anal levator muscles and pelvic floor tissues, which is also a common cause of rectal prolapse.

3. Other injuries

The surgery causes lumbar sacral nerve paralysis, resulting in relaxation of the anal sphincter and rectal mucosal prolapse.