RECTAL PROLAPSE

What is a rectal prolapse? A rectal prolapse occurs when the normal supports of the rectum become weakened, allowing the rectum to drop down outside the anus. Sometimes this only happens when you open your bowels, and the prolapse goes back on its own. In more severe cases, the rectum may need to be pushed back after opening the bowels, or may even stay outside all the time. While not a dangerous or life-threatening condition, this can be very uncomfortable, a considerable nuisance, and may cause loss of bowel control.

How will the operation help me? Your rectal prolapse is bad enough or troublesome enough to need an operation. A Rectopexy operation aims to prevent further prolapse. This operation involves a laparocopic abdominal operation through which your surgeon will fix the rectum back into place. There are a number of different operations that can be done, some of which sew the rectum back into place, others use a sling to fix it in place. Your surgeon will discuss with you what is recommended in your particular case.

What preparation is needed before the operation? You will be admitted into hospital the day before your surgery. You may be given some medicine to make sure that your bowels are empty.

How will I open my bowels? From the day after your operation you will be given laxatives to soften your stools and stimulate a bowel action. You may not feel the need to open your bowels for a day or two. When you do, you may experience some pain, discomfort and a little bleeding.

How long will I be in hospital? We will usually want you to stay in hospital until you are reasonably comfortable when having your bowels open. This is usually 3-4 days after the operation, but this can vary a lot between individuals.

How long should I stay off work? The time taken to get back to normal activities varies a lot for different people. Do as much as you feel comfortable doing. If lifting causes you discomfort you should avoid it. Most people need about 2-3 weeks off work, but this will depend a little on what you do, and it is important for you to pay attention to your body, and only do as much as you feel able to. You should try to avoid excessive walking or sitting still until your wound has healed.

Are there any long-term effects of the operation? In a few cases where someone has weak muscles around the back passage (anal sphincter) and a tendency to difficulty in controlling the bowels, or leakage, this may not improve immediately after the operation. Give it time -it can take several months for things to settle down following surgery. Sometimes some exercises to strengthen the sphincter will help. Some people find that they have a tendency to be constipated after a rectopexy. It is important not to strain and you may need to use occasional laxatives or suppositories to manage constipation. In some patients after a Rectopexy operation rectal prolapse can come back. The best way of helping to prevent this is to avoid heavy lifting and straining to open your bowels.

How diet can help? If you have a tendency to constipation, try to increase the amount of fibre in your diet. Fibre forms the structure of cereals, fruit and vegetables. It is not completely digested and absorbed by the body, so it provides bulk to the stools. This helps the movement of waste through the intestines, resulting in soft stools which are easy to pass.

• Increase the amount of fibre in your diet gradually -a sudden increase can cause abdominal discomfort and wind.
• If fibre in your food is not enough to keep your stool soft then consider taking a fibre supplement, such as Fybogel.
• It is also important to ensure that you drink plenty of fluid. Try to take at least 6-8 cups of fluid a day.
• The fluid you take can be any type, including water, tea coffee, unsweetened fruit juice, squash or soup.
• If you feel that you would like further guidance on diet, see a dietician.

FOODS RICH IN FIBRE Wholemeal bread, Wholegrain cereals (e.g. shredded Brown rice wheat, Weetabix, Branflakes, muesli) Fruit (especially if eaten with skin or Wholemeal pasta ) Wholemeal biscuits (e.g. digestive, crispbread, oatcakes) beans) Vegetables (especially if eaten with Nuts, seeds, and dried fruit skin or seeds, e.g. jacket potatoes)