Rectal Intussusception

Internal rectal intussusception is sometimes labeled "occult rectal prolapse" as the conditions are quite similar at defecography, with the only difference that rectal intussusception does not extend beyond the anal verge.

Internal intussusception is associated with several different functional complaints. Johansson and colleagues (1985) examined 190 patients with rectal intussusception and found that 57% of patients experienced a sensation of obstruction, 44% had fecal incontinence, 43% had painful defecations, and 27% had anal bleeding. Mucous discharge and diarrhea have also been reported.

The most common symptom associated with internal intussusception is, thus, obstructed defecation. This can be explained by several mechanisms. The intussusception, sometimes together with a concomitant enterocele and/or rectocele, may restrict emptying or produce a sensation of rectal fullness. The intussuscepting bowel, present in the rectum, may be experienced by the patient as fecal material that cannot be expelled. Continued straining will then increase the size of the intussusception and further worsen symptoms.

The association between the internal rectal intussusception and the above-mentioned symptoms remains unclear. Surgical correction of the anatomical intussusception does not always alleviate symptoms and rectal intussusception is a frequent finding in patients with defecation disorders. In an evaluation of 2,816 defecography investigations, we found that 31% of the patients had a circumferential rectal intussusception (Mellgren et al, 1994). Rectal intussusception has also been reported to be a frequent finding in defecography studies of healthy volunteers (Shorvon et al, 1989; Goei, 1990).

Constipation Prescription

Constipation Prescription

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