# Diagnosed with internal rectal prolapse today - very depressed



## Ouchie81 (Nov 26, 2013)

Hello,

I was diagnosed with an internal rectal prolapse today. I was told I will need surgery or in time I will become incontinent and the rectum will prolapse externally. I am terrified, depressed, mortified.... I have cried all day. I'm only 33. I thought I had IBS but turns out it's a prolapse, or maybe both. 
I am having dark thoughts, I'm not ok at all.
I guess I hoped to talk to someone or someone knows about this or is going through this


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## rewinj (Apr 19, 2012)

Hey, at least you have a possible answer/fix. I'm 30 too, and have been diagnosed with the same thing (which is a full thickness rectal prolapse now...) Apparently it's not that uncommon for skinny/weak young people. Surgery for this is relatively straightforward & successful from what I've heard (as far as gastrointestinal surgeries go, that is), and could eventually leave you with a fully-functioning gut, something many people with IBS can barely hope for.

I've also been diagnosed with SMA syndrome, which has a 1/3 chance of mortality and will probably require another, much more difficult surgery. Things could be much worse Ouchie81, so try not to despair too much! Find a good surgeon or surgeons, along with a good pelvic floor physio, who you can discuss this with (and whether or not your situation truly demands surgery.) I also would recommend finding a psychologist who is well-versed in IBS/gut problems.

Good luck. Stay strong!


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## Colt (May 5, 2011)

Agree with Rewinj....at least you have a diagnosis. There are others who have had prolapses corrected successfully. Relax as much as you can, and go through the procedures.


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## Ouchie81 (Nov 26, 2013)

I truly did think I would be happy when I found out what the issue is. I guess I had always hoped it was something minor, or that it really was IBS. Instead I feel terrified.
Rewinj I am so sorry to hear about your other condition. I had to google it. It sounds scary. Your a brave man. Can they do both surgeries at the same time? When are you having your surgery for the prolapse? You are in my thoughts.


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## QuietDesperation (Jan 17, 2014)

I have also been diagnosed with internal full thickness rectal prolaps and I'm only 25. I think I've been through the emotions you have right now, but it got better with time. Once I learned that most surgeries are infact successful I gained a lot of confidence. Why? The vast majority of people with this problem are old and fragile. There is likely a much greater chance of success when you are young.

The good news is that you have been diagnosed. You know what's wrong and how to treat it. You don't have an external prolapse and you are not incontinent. That would be a much worse situation.

I've been doing pelvic floor exercises and I have found that to be helpful. I recommend those while you wait for treatment.

Also interesting what rewinj said about skinny people. I fit that description. Didn't know about that.


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## IndianRopeTrick (Jul 25, 2013)

rewinj said:


> Full thickness rectal prolapse - Apparently it's not that uncommon for skinny/weak young people.
> 
> I've also been diagnosed with SMA syndrome, which has a 1/3 chance of mortality and will probably require another, much more difficult surgery.


"Full thickness rectal prolapse" - Does it really affect skinny people more ?

I found a nice link for this - http://emedicine.medscape.com/article/2026460-overview


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## QuietDesperation (Jan 17, 2014)

IndianRopeTrick said:


> "Full thickness rectal prolapse" - *Does it really affect skinny people more ? *
> 
> I found a nice link for this - http://emedicine.medscape.com/article/2026460-overview


I found this:

"A finding common to all 68 patients is a trend towards tall patients of modest BMI"

Source: http://www.bristolsurgery.com/article.aspx?articleid=100876

Also interesting is the whole study which concludes:

"LVMR is an effective treatment of external and symptomatic internal rectal prolapse [ODS, faecal incontinence, pelvic pain] in males leading to significant improvements in QOL and function scores."


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## marleyma (Aug 13, 2014)

I am 26f and had a full rectal prolapse which I had for 2 years before anyone took me seriously. I got the surgery anddd... three months later it returned. My doctors are basically throwing their hands up. They don't have much (if any) experience with someone so young with it. Now, through my own research, I will be seeing a rheumatologist to look into connective tissue disorders. Pleaseee ask questions and don't jump right into surgery. I thought it would be my quick fix. Now im even worse than before.


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## QuietDesperation (Jan 17, 2014)

marleyma said:


> I am 26f and had a full rectal prolapse which I had for 2 years before anyone took me seriously. I got the surgery anddd... three months later it returned. My doctors are basically throwing their hands up. They don't have much (if any) experience with someone so young with it. Now, through my own research, I will be seeing a rheumatologist to look into connective tissue disorders. Pleaseee ask questions and don't jump right into surgery. I thought it would be my quick fix. Now im even worse than before.


Did you have external prolapse or internal prolapse?

It's very rare that prolapse returns after surgery, how was things for you before it returned (during those 3 months post-surgery)? and how are you worse of? what surgery did you have?


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## marleyma (Aug 13, 2014)

I had full external. I was ok for maybe the first month.. I felt like I was on the road to recovery. Then everything started going downhill and I just felt like crap overall. Im now constipated alllll the time (I never was before) and my life day to day is just really hard. I have a hard time even forcing myself to work. I had a rectopexy with my rectum tacked up to tailbone with sutures and 6 inch colon reduction.


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## IndianRopeTrick (Jul 25, 2013)

marleyma said:


> I had full external. I was ok for maybe the first month.. I felt like I was on the road to recovery. Then everything started going downhill and I just felt like #### overall. Im now constipated alllll the time (I never was before) and my life day to day is just really hard. I have a hard time even forcing myself to work. I had a rectopexy with my rectum tacked up to tailbone with sutures and 6 inch colon reduction.


I feel so bad for you. Did your doctors even suggest trying dietary and lifestyle changes for the long term before taking such an extreme step ?


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## marleyma (Aug 13, 2014)

By the time they (I) diagnosed it (I took a picture, googled it and was like oh shit) it was wayyyy far gone. There was really nothing else I could do. I was already at the point of having to manually push it back myself. I was scared it wouldn't go back soon. As far as now, it's not that bad (it is full external though) but when I ran back to surgeon after I realized she was kinda like hm.. well, I dont know what to say. REALLY!? I shouldn't of had this at all to begin with and she was acting like no biggie! Stupid doctors.


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## IndianRopeTrick (Jul 25, 2013)

marleyma said:


> By the time they (I) diagnosed it (I took a picture, googled it and was like oh ######) it was wayyyy far gone. There was really nothing else I could do. I was already at the point of having to manually push it back myself. I was scared it wouldn't go back soon. As far as now, it's not that bad (it is full external though) but when I ran back to surgeon after I realized she was kinda like hm.. well, I dont know what to say. REALLY!? I shouldn't of had this at all to begin with and she was acting like no biggie! Stupid doctors.


Sorry, I am not able to understand. Did your doctor understand your problem well ? Did she suggest non-surgical options before surgery ? I ask because I am curious to know.


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## marleyma (Aug 13, 2014)

She did understand it. She said it was probably due to weak pelvic floor. By the time I went to her, surgery was really my only option. I was almost at the point of having the prolapse come out during everyday activities (walking, coughing etc) and I just could not live like. She could not tell me why it came back though.


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## IndianRopeTrick (Jul 25, 2013)

marleyma said:


> She did understand it. She said it was probably due to weak pelvic floor. By the time I went to her, surgery was really my only option. I was almost at the point of having the prolapse come out during everyday activities (walking, coughing etc) and I just could not live like. She could not tell me why it came back though.


Oh, so much prolapse is really bad. Do you have any guesses as to why you had prolapsed so much ? I am wondering if this has something to do with your diet. What was your diet like, from childhood to now ?


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## marleyma (Aug 13, 2014)

It has always been on the healthy side, especially in my adult years. I never had any issues with constipation until post surgery.


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## QuietDesperation (Jan 17, 2014)

rewinj said:


> Hey, at least you have a possible answer/fix. I'm 30 too, and have been diagnosed with the same thing (which is a full thickness rectal prolapse now...) Apparently it's not that uncommon for skinny/weak young people. Surgery for this is relatively straightforward & successful from what I've heard (as far as gastrointestinal surgeries go, that is), and could eventually leave you with a fully-functioning gut, something many people with IBS can barely hope for.
> 
> I've also been diagnosed with SMA syndrome, which has a 1/3 chance of mortality and will probably require another, much more difficult surgery. Things could be much worse Ouchie81, so try not to despair too much! Find a good surgeon or surgeons, along with a good pelvic floor physio, who you can discuss this with (and whether or not your situation truly demands surgery.) I also would recommend finding a psychologist who is well-versed in IBS/gut problems.
> 
> Good luck. Stay strong!


Hey

I read your other topic that you were going to have surgery for prolapse in August..Did you have the surgery ? It would be great if you could give some feedback on how it went, if symptoms are now gone. What surgery you had, and if your prolapse was internal or external. etc


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## ray220 (May 5, 2014)

My doc recommend starr. Does anyone has experiences with it


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## QuietDesperation (Jan 17, 2014)

ray220 said:


> My doc recommend starr. Does anyone has experiences with it


I don't have any experience with the operation myself, but I have been reading a lot about it. What I have learnt is that STARR is suitable for mucosal prolapse and perhaps if you have some minor intussusception.

However if you have full internal rectal prolapse its better treated with laparoscopic resection rectopexy with sutur or mesh. STARR is basically removing excess tissue, so if you have a full prolapse you are not really fixing the problem although it may help relieve some symptoms. You are basically cutting off tissue instead of lifting the rectum up in the position it should be. That may lead to being able to hold less stool, a lot of pain during recovery as it heals, but most importantly it could also lead to incontinence due to the way the operation is performed. STARR is a pernerium procedure where the stapler device is put through your anus. This could stretch your anal muscles and could cause damange. Many patients will have urgency after the operation and this can last for months. STARR also has higher recurrence rate than laparoscopic.

That said, there are also many successful operations performed with STARR. If you have descended perineum you are not eligble for STARR, so make sure that this is determined in an x-ray defecography test. Some has both mucosal prolapse / anal prolapse AND rectal prolapse, for those it may be necessary to do both laparascopic to fix the prolapse and STARR to get rid of excess mucosal tissue.

Personally I would be very worried about doing STARR for an internal rectal prolapse. It seems much safer (and better in actually treating your problem and symptoms) doing it laparoscopically.

Maybe someone here who has had the operation could give more info. This is just my personal opinion after reading dozens of reports and studies on this subject.


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## ray220 (May 5, 2014)

What is the difference between full internal and muscosal. My x ray defecography indicates i have intusscetpion that fall into my anal canal and no external prolapse noted


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## ray220 (May 5, 2014)

Moreover, it is hard to find data about men having this type of surgery. What is your symptoms? My symptoms are thin stool, feeling of obstruction and struck and need of enema or laxative to have bowl. Thank you very much.


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## Ouchie81 (Nov 26, 2013)

Mucosal is just the lining of the rectum, full thickness means the rectum comes out if you anus and intusseception means the prolapse is internal and the bowel is telescoping on itself


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## Stardock (Nov 8, 2012)

QuietDesperation said:


> I don't have any experience with the operation myself, but I have been reading a lot about it. What I have learnt is that STARR is suitable for mucosal prolapse and perhaps if you have some minor intussusception.
> 
> However if you have full internal rectal prolapse its better treated with laparoscopic resection rectopexy with sutur or mesh. STARR is basically removing excess tissue, so if you have a full prolapse you are not really fixing the problem although it may help relieve some symptoms. You are basically cutting off tissue instead of lifting the rectum up in the position it should be. That may lead to being able to hold less stool, a lot of pain during recovery as it heals, but most importantly it could also lead to incontinence due to the way the operation is performed. STARR is a pernerium procedure where the stapler device is put through your anus. This could stretch your anal muscles and could cause damange. Many patients will have urgency after the operation and this can last for months. STARR also has higher recurrence rate than laparoscopic.
> 
> ...


That's true, I've had Perianal Delormes procedure (through the anus) for my full-thickness rectal prolapse and now I can no longer hold stools for long periods of time like I used to. When I need to go, I need to go very soon. And since the surgery, a little bit of wet stool always leaks on the surface of my anus which didn't happen before. I wanted to have the keyhole surgery (through the abdomen) because of higher success rate but my surgeon wouldn't want to do it because there's 1% risk of impotence for males. I don't know about being weak, but I'm on the skinny side as well so perhaps there is a correlation. But the predominant reason why I've developed rectal prolapse was because I didn't resolve my constipation problem soon enough and the medication I was given from my doctor for my constipation (Bascopan Forte) only made my constipation worse. Moral of the story, don't strain too hard when you're constipated and don't stay constipated for too long.


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## tatyana (Jun 8, 2015)

Hello my name is Tatyana I been suffering with internal rectum prolopse 5 years if any one there can tell me symptoms of rectal prolopse I would be so grateful to that person , because I been going to doctors for 5 years without any diagnoses and everytime I'am telling to doctors about rectal prolopse they don't want to listening to me or test me for it please help me anybody !!! Thank you !!!


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## Ouchie81 (Nov 26, 2013)

I think the symptoms vary. Possible ones are: pain, difficulty opening your bowels, blood, rectal discharge, trapped wind, pressure in your rectum. I have the discharge and occasional pressure. What are you symptoms


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## tatyana (Jun 8, 2015)

Hi my symptoms are pain below belly button somedays left abdomen rectal pain a lot bowel movements only small stools having trouble to push through , I have this already 5 years going from one doctor to another and no results every day crying in paiin i'am very bloaded have a lot of headaches every day , one time I push so hard on toilet when stomach was cramping red tissue was on side of my anus and next to anus was little red lump I heard that sign of rectal prolopse but i'am not sure , thank you so much !!!


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## rewinj (Apr 19, 2012)

You have to see a colorectal surgeon for the proper tests/diagnosis. It seems GIs and GPs have very little knowledge of pelvic floor issues. A pelvic floor physio would also understand/help, but couldn't give you an official diagnosis. For women, I imagine a gynaecologist or OBGYN would surely help. Surgeons can't offer much outside of surgery though, and a prolapse is really probably a secondary issues. Be sure to consider what caused it to develop. Also be sure to get lots of opinions about any surgical advice offered.


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## tatyana (Jun 8, 2015)

Thank you so much i'am going to doctors every week without results not even one doctor can give me answers just sending me from one doctor to another I wish I knew that test I can ask doctor to run on me to fun out if I have rectum prolopse ?


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## rewinj (Apr 19, 2012)

Beyond a rectal exam from a colorectal surgeon, the test you most need need is a defecogram, aka defecogrpahy (also known as proctography, defecating/defecation proctography, evacuating/evacuation proctography or dynamic rectal examination).

https://en.wikipedia.org/wiki/Defecography


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## rewinj (Apr 19, 2012)

However, just because defecography shows something, it doesn't mean that is the root cause of your issues. Healthy asymptomatic people can have some degree of prolapse occurring, and prolapsing bowel can be fixed through methods outside of surgery (i.e. fixing your posture, pelvic floor exercise, dietary changes, treating other undiagnosed conditions etc.). A defecography is often a step towards surgical treatment, and while that is what some people do need, bowel surgery carries with a huge range of possible long-term complications and functional outcomes.


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## tatyana (Jun 8, 2015)

Thank you so much for your help my doctor so lazy she just won't run any test she ordered ct scan and of course test didn't showed nothing wrong and now she won't run any test , is that defecography test Like colonoscopy test ?


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## QuietDesperation (Jan 17, 2014)

tatyana said:


> Thank you so much for your help my doctor so lazy she just won't run any test she ordered ct scan and of course test didn't showed nothing wrong and now she won't run any test , is that defecography test Like colonoscopy test ?


Defecography is an x-ray test that shows how your rectum/anal canal changes during defecation. Basically what they do is they fill your rectum with x-ray barium paste and you have a bowel movement while being video taped with x-ray. This test is usful for identifing rectal prolapse or other issues such as rectocele If you suspect that you have an internal prolapse, get scheduled for x-ray defecography. That's what gave me my diagnose.

Here is a picture of the room where I did defecography, just to give you an idea of what it's like


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## myers (Mar 30, 2016)

Alwayschris247 said:


> I recently got told by my doctor that I was misdiagnosed with ulcerative colitis and that I actually have rectal prolapse. She didn't explain much further only saying that I should meet with a colorectal surgeon and he would explain. My appointment is a little over a month away and I have no idea what to do? I aim only 22 years old and have been dealing with a lot of embarrassing symptoms that have prevented me from living life the way I should I lost my job, friends, and I'm close to being homeless I've been like this for over a year.


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## myers (Mar 30, 2016)

What were your symptoms that they got confused with UC?


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