# prolapsed rectum or rectocele



## smason (Jan 7, 2002)

I am having symptoms consistent with either a prolapsed rectum or a rectocele. A GP I saw diagnosed a large rectocele, but the GI doctor that I saw could not detect one. He also did a colonoscopy that came out fine.So here are my questions.Is it possible that a rectocele or prolapsed rectum would not show up in the colonoscopy?If that's the case, what tests would clearly indicate whether or not I had a prolapsed rectum or a rectocele.Thanks for any input.Sarah


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## Tiss (Aug 22, 2000)

My rectocele did NOT show up on a colonscopy. My gynocologist diagnosed it. My GP didn't even diagnose it. Maybe you could go see your gynocologist. I thought my problem was in my rectum when actually it was the vaginal prolapse that caused the rectocele. It FEELS like the rectum is the primary problem, but it isn't.


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## honeybee (Sep 12, 1999)

Sarah, Please go see your ob-gyn, they are the doc that fixes rectoceles. According to your other thread on this subject your GP doesn't know anything about rectoceles anyway. A colonscopy will NOT show a rectocele, your ob-gyn can feel it with just a vaginal or rectal exam. A defacography test will also show a rectocele, but you do not want to do this test if you don't have to, you won't have to if you go to your ob-gyn. Good luck to you and call for an appoinment with your ob-gyn.


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## smason (Jan 7, 2002)

Tiss and Melissa,Thanks for your responses to my post.Two weeks ago I set up an appointment with the GYN that comes to our local clinic from Mayo Clinic in Rochester. The next available opening is not until February 28 so that's when I'm scheduled to go.That is waaaaaaaaaaaay to long for me to have to wait because I'm having a horrible time managing whatever my problem is. I called the clinic on Friday to try to talk to my GP about getting me in earlier. I was told that the GYN won't be here at all before February 28. The receptionist at the clinic told me I could call Mayo in Rochester direct and just set up an appointment to go straight there without a referral. When I called them, I was told none of the GYN's (which there must be a bunch of considering how big Mayo Clinis is) could see me for at least 3 to 6 months.Can you believe how difficult it is for me to see a GYN? I belong to a clinic affiliated with the world renowned Mayo Clinic and am fortunate enough to live within 70 minutes of Mayo Clinic in Rochester and it's nearly impossible to see a GYN.This is nuts. Anyway, that's why I'm still asking questions about how to get a definite diagnosis on the possible rectocele or maybe even a prolapsed rectum?Do either of you know if the colonoscopy would reveal a prolapsed rectum?I know this is going to sound strange, but when I'm having trouble passing things through the rectal area I've taken a mirror and tried to see what's going on. What I observed when is something bulging out of my rectum that looks like the outer tissue of some organ rather than the fecal material that takes quite a while to finally push it's way through as a narrowed stool. That's what made me think of rectal prolapse.Well, thanks again for your help.Sarah


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## Elizabeth Bucchieri (Jan 24, 2002)

Dear Sarah,I, like you, discovered a buldge also for almost a year...finally went to my GYN. He tried to insert a pessary, to push back inside some of my organs. Did not work...has extreme prolapse surgery done, due to bladder and bowel protruding out. I had a rectocele and cystocele done, re-constructed my anus. I know that it is almost impossible to get an appt. with Mayo, but I was fortunate to get an appt. with a Mayo Clinic GYN surgeon in a few days simply because my GYN knew this surgeon and he came highly recommended. They perfomed the surgery together. Hang in there Sarah, let me know if I can give you anymore insight on this. Good luck, Elizabeth


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## beth_crocker1 (Nov 7, 2000)

sarah, when I was first diagnosed with ibs, I came accross a article about prolapsed rectum and I immediately asked my gi doctor about this becaue I didnt have a clue what it was, and being the worry wort that I am I had to ask the doctor. Anyway I aked him about it and he said if you have a prolapsed rectum you would definately know it, because you would have to push things back up inside where they belong. And it would probly be a little uncomfortable when you were sitting if it wasnt pushed back in there. But if your really worried about it, you should definately ask your doctor about it.


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## smason (Jan 7, 2002)

Beth,It feels like something is always pushing on my rectal area.....feels like a brick in there....and, of course, the bowel movements are very difficult to maneuver out of my rectum even when they are soft.I'm also very uncomfortable sitting down no matter what. The pressure and discomfort is alleviated a bit when I'm standing up or lying down.Thanks for your input.Sarah


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## smason (Jan 7, 2002)

Elizabeth,Thank you for your comments.How do you feel after your surgery? Was your prolapse causing alot of problems for you? Did the surgery alleviate your symptoms?I appreciate your input. Sarah


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## honeybee (Sep 12, 1999)

Sarah, Could you call the doctor that believes you have a rectocele/prolapse and ask him/her to call the clinic for you to get a quicker appointment. Sometimes I have had a doctor do this and you definitely get in quicker. Might be worth a shot, especially if they know how uncomfortable you are. Good luck honey, my prayers are with you.


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## smason (Jan 7, 2002)

Melissa,A few weeks ago after the GI doctor said he couldn't detect a rectocele and after the colonoscopy came out fine I called the doctor I saw on call the week prior who said I had a large rectocele.He told me that he pulled my chart and saw the GI doctor's notes which indicated that I have a thinning vaginal wall. So then he said he thinks my problem is rectal spasms. I don't know how he went from a large rectocele to rectal spasms just by reading the GI doctor's notes in my file. I would think that if I were having rectal spasms they would somehow feel like a spasms. Anyway, I think I'll take your advice and call him. Something made him think I had a rectocele when he did the actual physical exam. So if I can make it very clear how impossible my situation is maybe he will get me in quicker. Thanks so much for your help and your concern, Melissa.Sarah


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## Elizabeth Bucchieri (Jan 24, 2002)

Hi Sarah,Believe me, I can really relate to you and your symptoms. Yes, I could not sit down either without experiencing such discomfort. The reason why you feel better lying down, which I did too, is because as my GYN told me, it retracts and goes back inside...when you get up and stand up, well, you know what gravity will do...there it went down and out again. Yes, I most definitely feel better after my prolapse surgery. It has been almost 6 yrs. now. The only thing I was told by my surgeon was not to strain or force when having a bm...which is difficult for me since I have constipation frequently. Let me know what you decide, and write to me if you feel it necessary.Have a great day....Elizabeth


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## smason (Jan 7, 2002)

Elizabeth,Could you actually see the prolapse upon visual inspection?Sarah


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## smason (Jan 7, 2002)

One more question, Elizabeth.....I had a colonoscopy that turned out fine a month or so ago. If I had any prolapsing of the rectum, wouldn't that have been noted during the colonoscopy....or is it possible it can retract when the colonoscopy is being performed?Thanks for your help.Sarah


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## teach (Oct 20, 2001)

Sarah and elizabeth:I had a rectal roplase a few years ago. I had to been seen by a colon rectal surgeon who made the final diagnosis. I had a bowel resection done which corrected the problem. See the surgeon... he knows for sure. HJR


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## Elizabeth Bucchieri (Jan 24, 2002)

Dear Sarah,In response to your questions: first, yes I was able to see the "buldge" as I took a mirror, then I spread my legs, I could see something hanging out that was like a pinkish color. I also let my husband see it. When I went for my usual Pap smear, my GYN saw it and I asked him what it was, then he told me. Advised me to have surgery performed by a specialist at the Mayo Clinic, who in fact was head of the GYN department. As far as a colonoscopy, I can't answer that since I never had one do. If you would like to e-mail me that isfine if you would like to speak on a one to one basis. I am not a doctor, just telling you what my case was. Have a great day...Elizabeth


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## C. Nicole (Feb 2, 2002)

Sarah,I joined specifically so I could respond to your question about rectal prolapse. I don't know what a rectocele is, but I have become the prolapse expert by experience. First, I am so sorry to read about your problem. If I can help you or anyone else, that would be great. The gross part of self diagnosis: take a mirror, strategically placed. If you can strain as if you are having a BM and can see tissue coming out of your rectum, bingo! The doctors confirmed diagnosis two ways: 1. the demonstration I described above (yes, you loose all modesty) and 2. you perform a deficating proctogram to establish where the rectum is detached and to design treatment. This test is a joy if you have ever wanted to be on film. Nuff said for now. I'm pretty sure these demonstrative tests are the only way to "show" the docs you have prolapsed rectum. Now keep me posted about your progress, and let me know if this progresses - I can walk you through the tests and beyond if you get to that point. Good luck and I really do wish you the best - no one should have to go through this. Smiles,Nicole


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## smason (Jan 7, 2002)

Nicole,Thank you for responding regarding my problem. I have been to my clinic on three different occasions to see three different on call doctors. Last night I saw one and told him I could see something bulging through the rectal area that looked like tissue or an organ. He told me that was normal. I had hoped that my observation would be key in a diagnosis. It made sense to me when I saw the bulging tissue rather than feces why I could not pass even soft stools without taking two fingers and vaginally manipulating the back of the vaginal wall. The tissue looked like it was creating a natural barrier to passing anything.The doctor I saw before him said that a prolapse or rectocele wouldn't create difficulty in eliminating and all this discomfort I'm having. He told me I should just add more fiber to my diet. I guess he figures that if I can't get soft stools out the fiber will help push it along. I'm afraid the increased gas during the fiber transition will be more than I can bear. I already have bad gas pains so often.At least the latest doctor said he didn't totally agree with the other doctor's comment. He said some women have horrible problems eliminating due to such conditions.Last night the doctor said I should just wait to see the GYN on February 28. I've been dealing with this for 5 or 6 months and have lots of pain and discomfort every single day.....If this is a prolapse, does surgery usually take care of the problem?Thanks again, Nicole.Sarah


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## smason (Jan 7, 2002)

I ended up having the defecating proctogram at Mayo Clinic in Rochester on April 30. The x-ray clearly indicated that I had an enterocele and a rectocele. The following day I met with the Professor of Surgery at Mayo Clinic. He reviewed the x-ray and agreed with the radiologist regarding the findings. He also had me sit on a toilet and push as though I were trying to have a bowel movement. He almost instantly diagnosed rectal prolapse after at least 6 months of seeking a diagnosis for this increasingly difficult problem.I had an abdominal rectopexy and with a rectosigmoid resection on May 17. The surgeon told me after the operation that the enterocele that was corrected was quite large and may have contributed to the urinary tract pressure and repeated urinary tract infections I was having since the small intestine was dropping so low into the pelvic/bladder region.He removed the enterocele and corrected the rectocele as he performed the correction of the rectal prolapse. He removed 8 inches of my sigmoid colon and pulled the rectum up into my body and sutured it to my sacrum (backbone). He also discovered that from birth my right side colon had been flopping around unattached to anything so he attached that part of my colon to my body. He also removed my appendix.I spent 6 nights in the hospital and returned home just a couple of days ago. The recovery is kind of rough. I'm hoping that this surgery helps me return to a normal lifestyle because I lost so much weight from not being able to eat normally and I had gotten to where I couldn't participate in most activities I enjoyed. I was even uncomfortable doing nothing.I'm rather disappointed that this problem wasn't pinpointed earlier.....especially since I told a GP at my local clinic that I suspected rectal prolapse 3 or 4 months ago. I'm not sure what would have happened. When I described the bulging from my rectum over the phone, the GP said that was normal. Funny that my body wasn't "normal" the first 43 years of my life. Now I'm in the midst of the tough road back to normal bowel movements. I had no bowel movement for the first 7 days after surgery so yesterday I was given the go ahead to try Milk of Magnesia. I was relieved to try because the abdominal discomfort since surgery has seemed to be more due to gas and colonic activity going nowhere than the wound discomfort.I was hoping for a good clearing of the bowel area but only had one loose bowel movement when I first woke up. It was awfully small and I've still felt full and distended since then.If anyone has experience with this sort of operation and recovery, I'd greatly appreciate any tips on how to get my body back in gear.Thanks,Sarah


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## Tiss (Aug 22, 2000)

I was finally diagnosed with a rectocele in January but what I believe I also have is an enterocele (sp?). I got the courage to look at my anus after a BM last week because I can feel a huge bulge down there that has gotten worse the last few years. The only way I can describe the way it looked it that it looks as if my anus is turning inside out. It was very gross looking. I have an appt. with my gyn next week and another appt with a colorectal surgeon the same week. I'm also having another colonscopy in a few weeks which I'm already dreading. I hate those things and cannot for the life of me understand why they refuse to put you out. The twilight anesthesia does not work for me. I remember and FEEL it all.


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## smason (Jan 7, 2002)

Good luck, Tiss!Your "inside out anus" sounds familiar to me. The time I looked at what was bulging out of my rectum I was shocked. The prolapse was creating an obstruction that made eliminating very difficult.I hope your doctors make an accurate diagnosis and suggest a treatment plan that will have good results.Sarah


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