Rectal prolapse is protrusion of rectal tissue through the anus to the exterior of the body. The rectum is the final section of the large intestine. Symptom severity will increase with the dimensions of the prolapse, and whether or not it spontaneously reduces once defecation, requires manual reduction by the patient, or becomes irreducible. The symptoms are similar to advanced hemorrhoidal sickness. Fecal discharge causing staining of undergarments, Rectal haemorrhage, mucous rectal discharge, Rectal pain, Pruritis ani.
The only potentially curative treatment for complete rectal prolapse is surgery, however in those patients with medical problems that make them unfit for surgery, and those patients who have minima symptoms conservative measures may benefit. Dietary adjustments, including increasing dietary fiber may be beneficial to reduce constipation,and thereby reduce straining. A bulk forming agent (e.g. psyllium) or stool softener can also reduce constipation. Biofeedback retraining may be indicated to help the patient avoid straining during defecation. There is limited evidence that hypopressive exercises may be beneficial in mild pelvic organ prolapse.
Postoperative pain was easily controlled in 12 patients by injection of xylocaine 2% in the epidural catheter (2 cc diluted in 10 cc saline given 8 hourly for 3 doses). In the other 8 patients, pain was controlled by diclofenac 75 mg i.m. injection 8 hourly for 3 doses. The median follow up period for patients included in this study was 65 months (range, 10–120 months).