Rectal prolapse
What's a rectal prolapse?
In the case of a rectal prolapse, part of the rectum falls down and comes out via the anus. At an early stage this can only happen during the pressing of the stool, after which the tissue automatically pulls back in again. In a more advanced prolapse it can also occur when walking, standing, coughing or other activities that increase the pressure in the abdomen.
In addition to coming out of the rectum, symptoms may arise such as a heavy or compressive sensation around the anus, mucus loss, blood loss, difficulty with stool and sometimes loss of stool.
A rectal prolapse is a physical subsidence. Acupuncture and Chinese herbal medicine can therefore have a mainly supportive role. In case of a clear or recurring prolapse, medical assessment is important and in case of more severe forms surgery may be necessary.
Common symptoms
The symptoms depend on the severity of the prolapse. Possible symptoms are:
- visible or palpable tissue coming out of the anus during stool;
- a heavy, pulling or compressive sensation around the anus or deep in the abdomen;
- the feeling that the stool is not complete;
- Mucus or blood loss;
- difficulty with stool or having to push a lot;
- loss of stool or reduced control of stool.
In a mild prolapse the tissue often recedes spontaneously or can be carefully returned. If the prolapse does not go back, becomes highly painful or dark red, purple or black discolours, rapid medical assessment is necessary.
Possible causes
A rectal prolapse usually results from a combination of weakening the supporting structures around the rectum and repeated pressure on the pelvic area.
Long-term compression in constipation can contribute to this. The same is true of chronic diarrhoea, which causes frequent stresses on the rectum. A chronic cough can also play a role due to the recurrent increase in abdominal pressure.
Other factors include aging, weakening of the pelvic floor and pregnancy and childbirth. Especially after multiple or severe births the supportive tissues may be weakened.
What can acupuncture do?
Because a rectal prolapse has a structural weakness, acupuncture cannot restore the anatomical support of the rectum as an operation can. Within a wider treatment course acupuncture can be used to treat factors that cause or worsen the prolapse.
Depending on the picture of complaints, treatment may be directed at:
- strengthen the Spleen-Qi and support the so-called "Downing Qi' when weakness and subsidence are central
- regulate intestinal function to reduce chronic diarrhoea or constipation and thereby repeated pressing
- Supporting Qi and Blood when symptoms have occurred after pregnancy or childbirth
- support lung function when chronic cough increases abdominal pressure and prolapse
- Dampness-Heat reduce when prolapse coincides with chronic diarrhoea, irritation, burning sensation or redness
Bone floor training can also be an important part of the treatment and is preferably accompanied by a specialised pelvic physiotherapist.
What can Chinese herbal medicine do?
Chinese herbal medicine is also tailored to the underlying pattern and factors that sustain the prolapse.
For example, within Chinese medicine herbs can be used to:
- To strengthen and raise Qi when subsidence coincides with general weakness
- Spleen and Stomach support for chronic thin stools and weak digestion
- Qi and Blood supplement if symptoms have occurred after pregnancy or childbirth
- Support Lung-Qi when chronic cough is an important burden factor
- Spleen and kidney-yang heating in case of obvious crucibility, weakness and prolonged complaints
- Dampness-Heat to reduce in case of diarrhoea, irritation, burning and inflammatory symptoms around the anus
Chinese herbs do not replace regular treatment with a severe prolapse. If surgery is necessary, acupuncture and herbs can be used in addition, e.g. for bowel movements, general condition and other complaints.
How does Chinese medicine view rectal prolapse?
Within Chinese medicine rectal prolapse is usually seen as a form of subsidence due to insufficient supportive Qi.
Especially the TCM organ system of the Spleen is important. The Spleen does not only relate to digestion within TCM, but is also associated with supporting and keeping tissues and organs in place. If Spleen-Qi is weakened for a long time, this support function may decrease according to TCM. This is also called sinking Qi.
In addition, the Lungs can be involved. Lung-Qi supports the movement of Qi through the body within TCM. Chronic cough can also mechanically increase the pressure in the abdomen and thus strengthen a prolapse.
In case of long-term or more serious complaints, the kidney system can also play a role. Within TCM, the kidneys are associated with the strength and support of the lower part of the body. Therefore, especially in older or severely weakened people, as well as Spleen-Qi deficiency may be present.
Not every rectal prolapse is considered a deficiency patterns. In chronic diarrhoea with heat, irritation and inflammation symptoms, for example, Dampness-Heat can play an important role.
A recognizable combination of symptoms and symptoms is called a TCM pattern. Below are the most common patterns. Other patterns are possible and multiple patterns can occur at the same time. Not everyone with the same pattern has all the mentioned symptoms. The pattern is determined by the overall picture of complaints.
What is a TCM organ system?
A TCM organ system includes more than just the anatomical organ. It describes a coherent set of functions and processes. Read more about this at TCM basics .
What is a TCM pattern?
A TCM pattern is a recognizable combination of signs and symptoms that indicates what disruption according to Chinese medicine is at the forefront. Read more about this at TCM basics .
Most common TCM patterns
Spleen-Qi-deficiency with sinking Qi
Brief explanation
This is one of the most important TCM patterns for rectal prolapse. According to TCM, the Spleen does not have enough strength to support the tissues properly. This makes it easier to lower the rectal gut. Long-term diarrhoea, disease, overload and general exhaustion can contribute to this.
Common symptoms: a prolapse that occurs especially during the stool, walking or standing for a long time, feeling heavy or pulling around the anus, tiredness, low appetite, bloated abdomen and chronic soft or thin stools. The person may be pale and feel physically weak.
Examples of Western disorders: rectal prolapse, chronic diarrhoea and other breakdown symptoms.
Lung-Qi- and Lung-Yin-deficiency
Brief explanation
With this pattern, the prolapse is associated with a weakened lung function. Especially long-term coughing can increase the pressure in the abdomen over and over again and thus strengthen the sagging.
Common symptoms: rectal prolapse in combination with chronic cough, shortness of breath, weak voice, tiredness and easy colds. In addition, Yin deficiency can prevent dry throat, dry skin, dry stools and sometimes night sweats.
Examples of Western disorders: rectal prolapse in chronic cough or chronic respiratory problems.
Kidney-Yang-deficiency
Brief explanation
In case of prolonged or more severe complaints, in addition to Spleen-Qi deficiency, the kidney-Yang may also be weakened. According to TCM, support for the lower part of the body decreases further. This pattern is seen more often in older or severely weakened people.
Common symptoms: a more pronounced or persistent prolapse, a heavy feeling around the anus, strong tiredness, crookedness, cold legs, weak or painful lower back and knees and frequent urination problems such as frequent or nocturnal urination. Chronic diarrhoea or constipation with dry stools may occur.
Examples of Western disorders: long-term or more severe rectal prolapse, especially in the elderly or with general weakening.
Dampness-Heat in the Intestines
Brief explanation
Dampness-Heat is central not only to weakness but also to irritation and accumulation in the Intestines. This pattern can occur with long-term diarrhoea or other chronic bowel problems and may continue to burden the tissues around the anus.
Common symptoms: prolapse with heavy or compressive sensation, urge without complete stool, burning or pain around the anus and red or dark coloured mucous membrane. Mucus or blood may be present. In addition, there are often diarrhoea or difficult stools, dry or bitter mouth and dark urine.
Examples of Western disorders: rectal prolapse in chronic diarrhoea, chronic bowel inflammation or other long-term bowel problems.
Qi and Blood deficiency after childbirth
Brief explanation
After pregnancy and especially prolonged or severe childbirth, both Qi and Blood may be weakened. At the same time, pelvic floors and supporting tissues may have become mechanically strained. This can create a prolapse or become clearer.
Common symptoms: rectal prolapse occurring during or after a pregnancy, feeling heavy or twitchy in the pelvis, tiredness, weakness, dizziness, palpitations, poor sleep and sometimes night sweats. Low back pain may also occur.
Examples of Western disorders: rectal prolapse after pregnancy or childbirth and pelvic floor weakness.
Outlook
The prognosis strongly depends on the severity and duration of the prolapse and the underlying cause. A mild prolapse that occurs only during the stool and easily withdraws offers more opportunities for conservative support than a large or persistent prolapse.
When acupuncture is used, once a week in the initial phase is a common guideline. In a mild prolapse a higher frequency can be considered temporarily. Chinese herbs can be used daily if there is an appropriate indication.
In the case of rectal prolapse, it is also important to treat causes of repeated pressure. Constipation and prolonged presses, chronic diarrhoea and chronic coughing therefore deserve specific attention. Pelvic floor therapy can also be important.
Severe, recurrent or irreducible prolapse requires conventional medical treatment, and surgery may be the appropriate option. Acupuncture and Chinese herbs can have no more than a complementary role in this situation.
Contact
Do you have a rectal prolapse and do you want to know whether acupuncture or Chinese herbal medicine can be of additional benefit to your complaints? During a first consultation, we look not only at the prolapse itself, but also at factors such as your bowel movement, digestion, energy level and any chronic cough or other complaints. On this basis, it will be assessed which support is appropriate and whether treatment within practice is useful.