It is an intestinal disease that occurs when the superficial layer or the entire layer of the last part of the large intestine prolapses after reaching the outside from the anus and herniates in this region with the contraction of the anus muscle.
The factor of multiple births and difficult births; It is the most important reason why this disease is more common in women than in men. Although it can be seen in the young age group, it is most common in patients over the age of 45-50. The main reason for this situation is that the tissue building blocks are not as tight as they are at a young age.
When we look at the causes of the disease, the most common factor is constipation that has been going on for years. It can be seen that almost all patients have these complaints after long-term constipation. Apart from constipation, diseases and tissue diseases that provoke the intestine to protrude outwards can cause rectal prolapse (intestinal prolapse).
Continuous coughing, which increases intra-abdominal pressure, and excessive strain during exercise can also cause rectal prolapse (intestinal prolapse).
Complaints in most patients; These are complaints related to the part of the intestine that is directly palpable due to the protrusion of a part of the intestine during toilet use. Apart from this, there is difficulty in going to the toilet, a feeling of blockage at the exit, a feeling of constant straining, a feeling of not being able to fully empty the toilet, and the feeling that there is an obstacle or dam here and you are trying to overcome it.
Rectal prolapse (prolapsed bowel) disease, hemorrhoids (piles). ) can often confuse the disease. In this case, what the patient says should be listened to carefully.
The diagnosis of the disease can be made by seeing the intestinal segment that comes out by asking the patient to strain during anal examination. For this reason, physical examination has an important place in bowel prolapse, that is, rectal prolapse disease.
In suspicious cases, computerized defecography and pelvic MRI can help in diagnosing the disease.
Treatment of rectal prolapse (bowel prolapse) disease; It should be planned according to the patient's complaints and the level of intestinal prolapse. In patients with intestinal prolapse; If the accompanying comorbidity, ongoing constipation or diarrhea are treated, the disease may resolve as rectal prolapse (intestinal prolapse). It is dying. For this reason, the treatment approach aimed at the patient, not the disease, is the most important approach, as in all other intestinal diseases.
In patients with advanced rectal prolapse (intestinal prolapse), the treatment most often applied to patients who do not respond to dietary recommendations or medical treatment is surgical methods. Surgical methods may vary depending on the patient's age, rectal prolapse (prolapsed bowel) disease, and whether there is any accompanying disease. Surgical methods can basically be applied with two different mechanisms.
- The first of these is the process of removing the hanging part from the anal area and stitching, that is, approximating, the cut part there; It can be applied in early cases or in hernias that concern only the inner surface of the intestine, which we call mucosal prolapse.
- It is the process of hanging the intestine above the back wall of the abdomen, both closed and open from the abdomen; It can also be applied to patients with advanced rectal prolapse (intestinal prolapse) and patients with longer intestine length than necessary.
In patients with rectal prolapse (intestinal prolapse) for many years, the muscles of the anus base and around the anus; It may cause various complications after the operation due to its weakening and deterioration of its anatomy. For this reason, patients need to be given detailed information about what they can experience about the treatment and the subsequent stages.
After the surgical treatment of rectal prolapse (intestinal prolapse), patients should be exercised with various devices to exercise the main muscles of the abdominal floor and around the anus, and should be advised to perform exercises prior to the disease.
If appropriate treatment is provided after the disease treatment, it is possible for patients to regain their social and business life and return to their normal lives.
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