什么是直肠脱垂？

Rectal prolapse is a medical condition in which the rectum starts to push through the anus. The rectum is the last part of your large intestine, and the anus is the opening through which stool exits your body.

Rectal prolapse affects about每10万人中有2.5人. Women over age 50 are six times more likely than men to have this condition. Sometimes rectal prolapse is suspected, but the problem is actually a serious case ofhemorrhoids.

Rectal prolapse can range from mild to severe. Mild cases can often be treated without surgery. Severe cases may require surgery.

There are three types of rectal prolapse. The type is identified by the movement of the rectum:

  • Internal prolapse.直肠开始下降，但尚未推出肛门。
  • Partial prolapse.Only part of the rectum has moved through the anus.
  • Complete prolapse.整个直肠通过肛门延伸。

The symptoms of rectal prolapse tend to come on slowly. The first symptom you’ll notice is the feeling that there is a bulge at your anus. It may seem as though you are sitting on a ball.

镜子,你可以see a reddish-colored bulge peeking through or actually extending out of your anus.

Sometimes during a bowel movement, a small part of the rectum will emerge but may retreat on its own or be easily pushed back into place.

正常的身体活动，例如行走，坐着和锻炼，也可能导致部分直肠推动你的肛门。起初，它可以用手返回其适当的位置。

If rectal prolapse worsens, there could be bleeding from the inner lining of the rectum. In cases of partial or complete prolapse, you may have trouble controlling liquid or solid bowel movements and gas from your rectum.

Chronicconstipationoccurs in30 to 67 percentof people with rectal prolapse, and about 15 percent experience腹泻.

Surgery is typically required to help repair rectal prolapse and treat symptoms such asfecal incontinenceand obstructed bowel movements.

Some types ofsurgeryinvolve making an incision in the abdominal wall and pulling the rectum back into place. This surgery, also known as abdominal rectopexy, can also be performed laparoscopically, using smaller incisions with a special camera and tools.

还有两种不同类型的会阴直肠切除术，其是通过阴部修复直肠脱垂的外科手术，或肛门和生殖器之间的区域。这些类型 是 :

  • Altemeier程序。这种类型的手术涉及去除伸出并将两个端部重新连接在一起的一部分直肠。
  • Delorme procedure.This procedure is ideal for those with shorter prolapses. It involves removing the outer lining of the rectum and then folding and stitching the layer of muscle.

这些手术通常推荐的人ho have severe constipation and are not considered candidates for a laparoscopic procedure through the stomach.

直肠脱垂手术后，您可能需要留在医院恢复并恢复肠功能。您在医院中花费的时间可能因您所拥有的特定类型的手术而有所不同。

在您的住院期间，您将慢慢过渡饮酒clear liquidsback to eating solid foods. Your doctor may also advise you on strategies to 避免复发 , or a return of rectal prolapse. These strategies may involve:

  • 保持水合
  • eating enough fiber
  • 使用粪便软化器防止便秘

通常，大多数人能够在手术的6周内完全恢复和恢复正常的日常活动。

Rectal prolapse can be caused by several medical conditions, including:

神经损伤

If nerves that control the rectal and anal muscles are damaged, rectal prolapse can develop. These nerves can sometimes be damaged from:

  • pregnancy or a difficult vaginal birth
  • a spinal injury
  • surgery in the pelvic area

Weakened anal sphincter

This is the muscle that prevents stool from involuntarily passing from your rectum. Common reasons this muscle may weaken are:

  • pregnancy
  • 分娩
  • 年龄增加

Chronic constipation

The strain of chronic bowel movement problems can make your rectum more likely to move down from its location. Straining while having bowel movements, if done often over a period of years, can also cause rectal prolapse.

While not directly linked to rectal prolapse, some conditions may increase the risk of it,包含:

Womenover age 50直肠脱垂的风险也增加。

If you’ve been diagnosed with rectal prolapse, you may choose to delay treatment if your symptoms are mild enough and your quality of life is not significantly affected.

If the prolapse is mild, softening the stool can help you strain less during bowel movements so you may recover without surgery before it gets worse. However, surgery is the only way to definitively treat rectal prolapse and relieve symptoms. The surgeon can do the surgery through the abdomen or through the area around the anus.

Surgery through the abdomen is performed to pull the rectum back up and into its proper position. It can be done with a large incision and open surgery, or it can be done laparoscopically, using a few incisions and specially designed smaller surgical tools.

Surgery from the region around the anus involves pulling part of the rectum out and surgically removing it. The rectum is then placed back inside and attached to the large intestine. This approach is usually performed in people who are not suitable candidates for surgery through their abdomen.

与医生讨论您的治疗方案。如果他们推荐一种类型的手术，你应该感到舒服地问它为什么推荐。

Your doctor 将要 询问您的病史，并描述了您的症状。他们还应该做一个完整的体检。在考试期间，您的医生可能会要求您蹲下和压力，好像你有一个肠蠕动。

Your doctor will observe your rectum and may place a gloved finger in your anus to check the health or strength of the anal sphincter and the rectum itself.

你也可以被定向有一个结肠镜检查检查任何息肉.

Rectal prolapse andhemorrhoidscan both be uncomfortable and painful conditions. Rectal prolapse may initially feel like a bad case of hemorrhoids, and sometimes hemorrhoids on your anus may look like your rectum is emerging.

Rectal prolapse involves movement of the rectum itself. Hemorrhoids are actually swollen blood vessels in the walls of your rectum or anus. Hemorrhoids are quite common in their smaller, milder form. They can become painful and itchy and can leave red blood on the tissue when you wipe. Rectal prolapse can also cause bleeding sometimes.

Read more: Why is there blood when you wipe?

如果你怀疑你有痔疮或直肠脱垂，请去看医生。他们可以诊断您的病情并开始适当的治疗方法。

Preventing rectal prolapse is not always possible. You can reduce your risk if you maintain good intestinal health. To help avoid constipation:

  • Make高纤维的食物part of your regular diet, including:
    • fruits
    • vegetables
    • bran
    • beans
  • Reduce the amount of processed food in your diet.
  • 每天喝大量的水和液体。
  • Exercise most, if not all, days of the week.
  • 用冥想或其他放松技术来管理你的压力。

Rectal prolapse may be associated with several serious complications.

它经常是原因ulcers在直肠中，这可能导致出血和疼痛。

它还可能损害括约肌，这是环形肌肉，打开和关闭肛门。这可能导致肠道控制的问题，包括粪便尿失禁。

在非常严重的情况下，它也可能导致施集，切断血液供应到已经推穿过肛门的直肠。这被认为是医疗紧急情况，需要立即外科干预。

The outlook is generally positive for someone undergoing rectal prolapse surgery. You’ll be on a diet of liquids and soft foods for a while, and you’ll need to take astool softenerat first. This is to prevent constipation or straining during a bowel movement.

手术后在医院花费的时间取决于您的健康和您所拥有的手术类型。大约6周内可以预期全面恢复。

Rectal prolapse can be uncomfortable and painful, but it’s treatable. The sooner you see a doctor about your symptoms, the easier the surgery and recovery will be.