Rectal prolapse is a full-thickness, circumferential intussusception of the entire rectal wall through the anal canal and anus. The prolapsing bowel itself, mucosanguineous discharge, bleeding, constipation and/or incontinence, and a feeling of incomplete evacuation, are the most frequent complaints. The incidence of preoperative incontinence and constipation has only been reported prospectively in a few studies and definitions vary. Allen-Mersh and colleagues (1990) studied 57 patients with rectal prolapse prospectively and found fecal incontinence symptoms in 49% and constipation symptoms in 30% of the patients. Madden and colleagues (1992) reported some degree of anal incontinence in 17 of 23 patients (74%) and constipation in 11 (48%) of their patients. In another prospective study, Huber and colleagues (1995) included 42 patients, 5 of whom had internal rectal intussusception. They found fecal incontinence in 54% and some degree of constipation in 44% of the patients.

The underlying mechanism for incontinence symptoms in approximately 50% of patients with rectal prolapse is not fully understood. Porter used needle electromyography and noted excessive reflex inhibition in prolapse patients. Recently, it has been demonstrated that patients with rectal prolapse have a thickened internal anal sphincter at endo-anal ultrasound (Marshall et al, 2002). Several mechanisms have been proposed to explain prolapse-associated incontinence. These include direct sphincter trauma caused by repeated stretching by the intussuscepting rectum or that the intussuscepting rectum leads to chronic stimulation of the rectoanal inhibitory reflex. Constipation, defined either as abnormally few stools per week or increased straining at stool may be explained by the presence of the intussuscepting bowel in the rectum, colonic dysmotility or inappropriate puborectalis contraction.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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