# Will this give me a prolapsed rectum?



## QuiQui (Aug 15, 2010)

Ok, this post might be a little graphic. Consider yourself forewarned. 

Usually, I try to keep my BMs soft, but lately I've been trying to take much less Miralax, and I've added a lot of flax seeds to my diet. The result is hard, large, misshapen stools that are really difficult to pass.

About a week ago, one got stuck partway in and partway out. No matter how hard I tried to push it out, it just wouldn't go out or even back in. So instinctively I pressed up with my fingers on the skin in front of my anus while I bore down with my muscles internally - kind of the same principle as clearing a clogged pore. The poop just popped right out!

My question is whether this is a good or bad technique. In my mind, I imagine my rectum is being forced down, while I'm forcing the surrounding skin up. That doesn't seem like a good thing, the way I'm imagining it. Can I do any damage to myself by doing this?


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## Kathleen M. (Nov 16, 1999)

It isn't clear, although it does seem more common in people with constipation and a lot of straining (as well as people with things that cause severe coughing).

Now it may be only if you were already prone from how your ligaments formed, and other things like child birth. There is some chicken and egg...which comes first the excessive straining or the anatomical problems, especially since the anatomy make make you more prone to need to strain.

Now if it reduces the amount of time straining that may be a good thing, but it may also put pressure on things which could be a bad thing, but I can't really tell as I can't feel what you are feeling when this works, but if it just prevents the straining by making it easier to pass the stools I would think more good than bad.

If you can tolerate fruits or other things that soften up the stools that may be something to think about if you really need to back off the miralax that much.


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## annie7 (Aug 16, 2002)

QuiQui

reading what you said about pushing on the perineum reminded me of a description i'd read recently about rectoceles and splinting:

"... many women with a rectocele will press up on the perineum or backward on the vaginal wall toward the rectum during bowel movements to compensate for the bulging and make defecation easier. Doctors call this "splinting." If you are doing this, you may have a rectocele ..."

http://womensvoicesforchange.org/ask-dr-pat-i%E2%80%99m-writing-about-an-embarassing-problem.htm

but that just talks about pushing on it (the perineum) to help facilitate a bm if you have a rectocele and stool gets hung up in there..

.i don't know about the bearing down part--if that would be damaging or not...kathleen had good advice about softening things up..


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## QuiQui (Aug 15, 2010)

Annie, that's an interesting thought. It doesn't really sound like I have a rectocele right now, but my grandmother had both a prolapsed uterus and anus (I think). I keep asking my gynecologist to look for any kinds of prolapse, and she keeps saying I don't have anything like that. Would she be able to see a rectocele in the course of a normal exam?

I'm thinking that the misshapen poop was maybe mimicking the effect of a rectocele. There was a big, crooked bulge in the middle of it, which was preventing me from pushing it out properly. Or, possibly I do have a rectocele, and the bulge was stuck in the rectocele? I hope not... Maybe I just have a thin perineum?


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## annie7 (Aug 16, 2002)

i'm not absolutely certain if a doc can tell for sure if you have a rectocele just during a normal exam. maybe. although my gyno mentioned she could feel mine a bit--this was after i'd already told her i'd had a defogram which had revealed a moderately sized rectocele as well as a vaginal prolapse. and the colo rectal surgeon said he could feel it slightly --also after i'd told him about it..

from what i've read and heard, the best way to dx a rectocele is to have a test called a defogram (defecatory protogram or defecography). this is a very useful and worthwhile test which can diagnose a number of problems. it can diagnose pelvic floor dysfunction--when your pelvic floor muscles aren't co ordinating properly so as to allow stool to pass. this test can also can reveal if you have other outlet problems as well, such as a rectal prolaspe, vaginal prolaspe, a rectocele (and the size of it if you have one) or enterocele etc.


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## AIRPLANE (Mar 15, 2004)

It seems that some doctors can diagnose rectoceles upon examination and many can't. I was diagnosed by a gynecologist several years ago with just a pelvic exam. She wanted to do surgery for it but I'd heard that she was surgery-happy and decided to get another opinion. I then went to a urogynecologist who thought that it shouldn't cause any pain or problems because it was small even though I have a lot of discomfort there- I can feel a bulge there constantly and sitting and even trying to get comfortable in bed is a problem He recommended physical therapy which I've tried but it didn't help. I'm hoping to do the biofeedback program at Mayo soon if I can get my insurance to cover it which in the past they wouldn't but I'm going to appeal.. I have difficult/incomplete evacuation even though my BMs are normally soft as I apparently have pretty fast transit everywhere else. I also have a pulling sensation that is probably due to adhesions which makes it worse.

I also had the defecography test that Annie mentioned. It seems that for most doctors that I've been to, that is the only way to diagnose it unless it is large enough. It is probably a good test to have if difficult/incomplete evacuation is an issue, especially if your BMs tend to be soft like they recommend.


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## Double Trouble (Apr 8, 2013)

It could. When you started taking flax seed, was it ground ? Did you increase the amount of water you drink a day ? Miralax helps to pull water into your colon and to retain water in your stool. I can understand your desperation in trying to expel that stool because I have had this awful painful experience when I have been that severely constipated.

I have learned that I can't allow myself to go more than 48 hours without moving my bowels. When I get to the 48 hour mark and haven't moved my bowels then I use a glycerin suppository to help soften the stool inside my rectum that is hard. Instead of excessively straining and trying to force the stool out, I take slow deep breaths and hold my breath for 15 seconds and slowly exhale through pursed lips and I keep doing this until I have been able to pass the hard stool. this keeps me from trying to force it out and it doesn't hurt as much either. Listening to relaxing music helps you to concentrate on your breathing so aren't tempted to strain.


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