Suggest treatment for rectal prolapse

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Posted on Mon, 8 Jun 2015 in Liver and Gall Bladder
Question: I suddenly sufferd a prolapsed rectum this past Thursday and was taken to the ER. A doctor pushed it back in. He told me it may occur again. He said if it happened again, to try to push it in myself or come back to the ER. I told him I was very worried about how I was going to have BMs after this. He said push, don't strain. It has now been 3 days and I am unable to have a BM! I am suffering terribly as I have immense pressure and fullness I'm my rectum. It feels like I must go urgently, but when I try, it's impossible! I don't think it is functioning properly. I can't force it. I'm terriffed the rectum will pop out again and I have days of waste in me. I feel impacted but I can't know for sure. Could the rectum be misplaced or bunched up, blocking elimination, as I have read? What can you suggest I do to get relief? I'll call to find a GI tomorrow but I am stuck over the weekend. It 's unbearable and I'm desperate. Can you please help me?
doctor
Answered by Dr. T Chandrakant 10 hours later
Brief Answer:
Visit ER ASAP, do not try anything at home.

Detailed Answer:
Hi.
Thanks for your query.

To recapitulate: Female/61 - suddenly suffered from rectal prolapse - Thursday - ER - Doc pushed it back - unable to have BM 3 days - immense pressure and fullness - feeling like to go urgently - can not force it -terrified that the rectum will pop out - feel impacted -
Questions about -
Could the rectum be misplaced or bunched up, blocking elimination, as I have read? > Yes this is one possibility due to straining voluntarily on your part and involuntary activity by the body. In addition you have been taking Doc-Q-Lace

What can you suggest I do to get relief? > Stop Doc-Q-Lace, take plenty of oral fluids. You have to go to the ER as you need assisted evacuation under medical supervision.
Please do not try anything at home.

I'll call to find a GI tomorrow but I am stuck over the weekend. It 's unbearable and I'm desperate. Can you please help me?
> It is already late, three day are over and you are suffering. Visit ER.

I hope this helps you and please feel free to ask any further relevant queries o if you feel that there is a gap-of-communication.



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 38 minutes later
Are you telling me there is nothing I can do and that I must go to the ER in this condition? They left me waiting for many hours with the prolapsed rectum biking down before a PA even spoke to me. I waited many more hours before she got a physician to push it in. I waited hours more for him to come over to talk to me. He told me if it reocurrs to push it in and if I couldn't, to come back to the er. I told him I was very concerned how I was going to have BMs after the rectal prolapse. IHe dismissed me in a condescending manner. Sure enough, after the prolapse I have been unable to move my bowels going on4 days this coming afternoon! I feel great pressure and am in intolerable pain and pressure. It feels different than constipationbefore this rectal prolapse. Another doctor said I could treat it at home with a rectal suppository, and Fleet enema. He also recommended daily doses of metamucil and drinking lots of water. But in my situation, I can't wait for a daily regimen to get results. I told him I would have to strain with an enema and I was told not to do that. But then how would I evacuate? I fear another prolapse in the midst of exertion. Now I'm very confused because you say not to use anything at home. I'm afraid to because of the possible consequences. But I can't stand going to ER and suffering in this condition for 8-12 hours with no guarantee of relief.
The ER physician also told me to take the Docqlace, except I was already taking it, so he took back his prescription. He advised me to keep taking it.
doctor
Answered by Dr. T Chandrakant 49 minutes later
Brief Answer:
You need an assistance to avoid complications

Detailed Answer:
Oh, I am so sorry to know the apathy of the staff at ER, this is not at all fair on their part.
I suggested for not trying anything at home for a few reasons:
Firstly, I knew nothing about your experience at ER.
Secondly, to try to push in the enema at home with this condition you explained and with the history of rectal prolapse where assistance was needed, it is going to be bit tricky and a bit dangerous as the anatomy may not be normal due to edema and all the changes inside the rectum. This better be done by an experienced person to avoid any complications. (this was my intention).
You can certainly try, but with a risk and if still the evacuation does not occur you have added load passed as enema causing you more trouble. Sometimes we need to put in the flatus tube to evacuate, that only a medical person can do.
Please do not be confused, get back to the ER, the reasons as explained and I hope you would agree with me.
These are not theoretical, these are practical points I have explained which wwe face from time to time.

If you read the literature of Doc-Q-Lace, it is specifically mentioned to stop if you do not pass motion. >) Do not use docusate for longer than 7 days unless your doctor has told you to. Call your doctor if your symptoms do not improve, or if you have not had a bowel movement within 1 to 3 days. Overuse of a stool softener can lead to serious medical problems. http://www.drugs.com/mtm/doc-q-lace-oral-rectal.html )

Please visit ER, who knows you get a better and considerate attendant.

I hope this helps you and please feel free to ask any further relevant queries o if you feel that there is a gap-of-communication.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 38 minutes later
I'm experiencing unbearable pain and pressure. I can't sit or lie down. There is no comfortable position.
I do understand your points very well. Thank you for explaining them to me more specifically.
However, I am extremely reluctant because of my harrowing experience in the ER. They kept me waiting for 4 hours before a Physicians Assistant spoke to me. Then, I waited hours more with the prolapsed rectum still hanging out before she had the physician finally come over to push it in. Consequently, I feel very upset and reticent about this option.
If I were to go to the ER in the condition I'm in now, I'd be suffering horribly as I'd have to wait for endless hours in that loud, freezing, crowded ER with no relief guaranteed! I couldn't endure it. I'm hurting so much, I'm writhing in pain!
I don't see any satifsfactory solution! I need help immediately and I can't get it.
doctor
Answered by Dr. T Chandrakant 16 minutes later
Brief Answer:
Please go to ER / Get a Medical Assistance

Detailed Answer:
I can can understand the plight you must be going through.
It is already 12 hours since you wrote the first question.

It is possible that looking at your pains and condition, they may give early attendance and assistance.

Immediate relief is possible only with evacuation.
Try the ER once again or if there is any other way you can get medical assistance.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 6 minutes later
Briefly, is there another way to get the necessary medical assistance, other than an ER?
doctor
Answered by Dr. T Chandrakant 46 minutes later
Brief Answer:
Your PCP / Family Physician or friends / family can tell you the best way.

Detailed Answer:
Oh, I was talking to colleagues about the best possible approach to solve your problem.

The options are:
Go to ER as you have to tide over the emergency and you may be admitted if necessary.
If you have Family Physician / PCP, you can get his guidance what best can be done.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. T Chandrakant

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Practicing since :1984

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