Rectal Prolapse Treatment in Bathinda

Q: What is rectal prolapse?

Rectal prolapse occurs when the rectum (the lower part of the large intestine) slips outside through the anus. It can be partial (internal — rectum folds on itself) or complete (external — rectum protrudes outside the body). It causes significant discomfort, bleeding, mucous discharge, and incontinence.

Q: Who is most at risk for rectal prolapse?

Rectal prolapse is most common in elderly women, though it can also affect men and younger people. Risk factors include chronic constipation and straining, multiple vaginal deliveries, previous pelvic surgery, weak pelvic floor muscles, and chronic diarrhoea.

Q: Can rectal prolapse be treated without surgery?

Dietary changes (high fibre, adequate fluids), stool softeners, biofeedback therapy, and pelvic floor exercises may help mild or internal prolapse. However, complete (external) rectal prolapse almost always requires surgical correction for definitive treatment.

Q: What is laparoscopic rectopexy?

Laparoscopic rectopexy (Frykman-Goldberg procedure) is the minimally invasive gold standard for rectal prolapse. The rectum is mobilized and fixed (sutured or with mesh) to the sacrum (tailbone) using 3–5 tiny incisions. It has excellent results — over 95% success rate with low recurrence.

Understanding Rectal Prolapse

Rectal prolapse — where the rectum protrudes through the anus — is a distressing and embarrassing condition that significantly impacts quality of life. Many patients suffer silently for years, unaware that highly effective surgical treatment exists. Dr. Raman Garg, Senior Surgical Gastroenterologist & Colorectal Surgeon at Bombay Gastro & Cancer Institute, Bathinda, specializes in laparoscopic rectopexy — the gold standard surgical treatment for rectal prolapse — with over 95% success rate and minimal recurrence.

Types of Rectal Prolapse

Mucosal Prolapse

Only the inner lining (mucosa) of the rectum protrudes. Common in children and adults with haemorrhoids.

Often misdiagnosed as piles

Internal Prolapse (Intussusception)

Rectum folds on itself internally but does not protrude outside. Causes straining, incomplete evacuation, pain.

Diagnosed by defaecography

Full-thickness (External) Prolapse

All layers of the rectal wall protrude outside the anus. Most severe type. Always requires surgical correction.

True rectal prolapse

Symptoms of Rectal Prolapse

A red/pink mass protruding from the anus (especially during straining)
Bleeding and mucous discharge from the anus
Feeling of incomplete bowel emptying
Faecal incontinence (inability to control bowel movements)
Constipation or straining during defecation
Sensation of something falling out of the rectum
Discomfort and perineal pressure
Anal pain (especially if prolapse becomes strangulated)

Diagnosis

Clinical examination — asking patient to strain (squat or seated on commode) to demonstrate prolapse
Rigid proctoscopy — assess mucosal folds and distinguish from haemorrhoids
Colonoscopy — rule out associated polyps, cancer, or IBD
Defaecography (MRI or fluoroscopic) — for internal prolapse diagnosis
Anorectal manometry — assess sphincter function and incontinence
Pudendal nerve studies — assess nerve damage contributing to incontinence

Surgical Treatment Options

Abdominal Approach (Preferred)

Laparoscopic rectopexy (gold standard) — rectum fixed to sacrum with sutures or mesh
Excellent functional outcomes
Recurrence rate <5%
Suitable for young and fit patients
Simultaneous sigmoidectomy if redundant sigmoid

Perineal Approach (Alternatives)

Delorme's procedure — mucosal stripping and plication of muscle
Altemeier's procedure — perineal rectosigmoidectomy
Used for elderly/high surgical risk patients
Higher recurrence rate (10–30%)
Avoids abdominal entry

Laparoscopic Rectopexy — What to Expect

Dr. Raman Garg performs laparoscopic rectopexy under general anaesthesia through 4–5 small port incisions. The rectum is fully mobilized from its attachments, fixed firmly to the sacral promontory (either with non-absorbable sutures or prosthetic mesh), and the bowel is repositioned anatomically. The procedure takes 60–90 minutes. Most patients start eating the next day and are discharged within 2–3 days.

Recovery Timeline:

Day 1 — Walking, liquid diet allowed
Day 2–3 — Discharged home; soft diet
Week 1–2 — Light activities; avoid heavy lifting
Week 4–6 — Full activity resumed; bowel habits normalize
3–6 months — Incontinence significantly improved in most patients

Frequently Asked Questions

What is rectal prolapse?

Rectal prolapse occurs when the rectum slips outside through the anus. It can be partial (internal) or complete (external). It causes significant discomfort, bleeding, mucous discharge, and incontinence.

Who is most at risk for rectal prolapse?

Rectal prolapse is most common in elderly women but can affect men and younger people. Risk factors include chronic constipation, multiple vaginal deliveries, previous pelvic surgery, and weak pelvic floor muscles.

Can rectal prolapse be treated without surgery?

Dietary changes, stool softeners, biofeedback, and pelvic floor exercises may help mild or internal prolapse. However, complete external rectal prolapse almost always requires surgical correction.

What is laparoscopic rectopexy?

Laparoscopic rectopexy is the minimally invasive gold standard for rectal prolapse. The rectum is mobilized and fixed to the sacrum using 3–5 tiny incisions. It has over 95% success rate with low recurrence.

Dr. Raman Garg