Rectal prolapse in children: Treatment and prevention of recurrence

The article was professionally consulted by Specialist Doctor II Tran Van Trong - Department of General Surgery - Vinmec Da Nang International Hospital

Rectal prolapse in children, commonly known as prolapse, is a condition in which the upper part of the rectum descends through the anus to come out. Rectal prolapse is common in children under 3 years of age and adults over 50 years of age.

Rectal prolapse, or folklore, also known as prolapsed dom – naturally, when parents see their child having to have a bowel movement, then there is a red-pink or slightly purple mass and the ball is right at the anal opening and is very alarmed. Rectal prolapse is the last part of intestine (also called rectum) that prolapses through the anal opening, usually in children under 3 years old and in adults over 50 years old.
Rectal prolapse is a benign disease, with few serious complications, but causes many troubles for children in daily activities and prolapsed bowel mass makes the baby's parents feel worried.

There are many causes of rectal prolapse in children. On one site of the baby, there is anatomical abnormality at the flexure between the rectal ball and the anal canal when the baby has behaviors that cause pressure on the perineum, such as: the child is constipated to have a bowel movement. strong, children with dysentery, diarrhea.... The rectum is easy to prolapse and can't go up.

Children who are weak, malnourished, often constipated, have a long bowel movement in the potty, and are prone to rectal prolapse from day to day.
Rectal prolapse is usually self-limited with a reasonable diet and lifestyle without the need for any surgical or surgical intervention.
Let the child sit in warm water for about 10 minutes. After letting the child press the dom block in, the adult helps to push the dom into the anus. Then let the child lie down, limit running and jumping after pressing the prolapsed block.

Most cases of rectal prolapse can be treated conservatively, waiting for the development of the body to help change and adjust the anatomical structure of the perineum. Children need to be actively treated for factors that promote rectal prolapse such as: constipation, dysentery, diarrhea, malnutrition
Surgical intervention is considered when:
Rectal prolapse after 4 years and mass sa over 3cm in length. Symptomatic: pain, bleeding, mucus discharge, perianal inflammation Post-operative rectal prolapse (Pullthrough) Consider surgery in children over 4 years of age Not self-limiting during 12-18 month follow-up

Most parents are very alarmed and take their children to the hospital, but you can do the following actions at home and still solve the problem:
Put the baby on his back, raise his buttocks high, and spread his legs. An assistant holds the baby's two kneecaps and holds them up to the sides. 1 person standing opposite the child's buttocks, use warm water to rinse the sacroiliac mass, use the fingers of the right hand to grasp the mass, use the thumb of the left hand to put it in the middle of the mass, combine 2 hands to push it slowly While the child's footkeeper slowly lowers the legs and gradually closes the legs, when the prolapse is pushed up, the baby's legs are straightened and the buttocks close, keep that position 20 -30 minutes, soothe the baby to avoid screaming because it may fall back.

Posture: Do not let the child sit on the potty or squat, it will increase pressure on the perineum and cause prolapse, so hold the child in the pee and poop position like when he was a child. Diet with enough fiber, enough water to prevent constipation. Oral anti-rotavirus, food hygiene to prevent diarrhea.

Children should not sit on the potty or squat when defecating, because in this position the anus expands and the rectum is in an upright position, so it is easy to prolapse. Should hold the baby on his back in a position with his back against the mother's lap, with both hands holding the child's thighs closed, like a baby's toilet position when urinating at a young age. In case the prolapsed mass is stuck outside and cannot be pushed up, the mother should use gauze soaked in warm water to cover the prolapsed mass and quickly take the baby to the nearest medical facility.
Babies with rectal prolapse need long-term follow-up examination under the guidance of the doctor, to have indications for surgical intervention when necessary.
Pediatrics department at Vinmec International General Hospital is the address for receiving and examining diseases that infants and young children are susceptible to: viral fever, bacterial fever, otitis media, pneumonia in children, .... With modern equipment, sterile space, minimizing the impact as well as the risk of disease spread. Along with that is the dedication from the doctors with professional experience with pediatric patients, making the examination no longer a concern of the parents.