RECTAL PROLAPSE

WESTERN MEDICINE: There are two types of rectal prolapse: mucosal (incomplete) prolapse and true (complete) rectal prolapse, which involves both the rectal mucosa and the rectal wall.

Rectal prolapse in children: Prolapse is almost always mucosal in type and occurs mainly in infants and children under 5. The usual cause is sitting too long at stool or straining at stool. The problem is self-limiting and usually responds to conservative measures such as forbidding prolonged sitting at stool, and the use of mild laxatives.

Rectal prolapse in adults: True prolapse is more common and is really a sliding hernia through the anterior wall of the rectum. It is usually due to weakening of the fascial supports of the rectum and of the levator ani through pelvic surgery, childbirth, or old age. Mucosal prolapse in adults is usually the result of prolapsing internal hemorrhoids.

ETIOLOGY AND PATHOLOGY: The direct location of rectal prolapse is in the large intestine. According to Chinese medicine, the lung is connected with the large intestine, the stomach is the source of all internal organs, the spleen is the "mother Qi" of lung, the orifice of kidney is anus and urethral orifice. So the dysfunctions of all those organs have a relationship with rectal prolapse. Its pathological factors are due to either the deficiency of internal organs or the descending of damp-heat due to irregular food intake or excessive alcoholic beverages.

DIFFERENTIATIONS:

1. Rectal prolapse due to the Qi Deficiency:

Indications: Rectal prolapse usually happens after defecating, or after coughing, walking, standing, urinating, there is no pain, reddish or swollen around anus, accompanied with fatigue, shortness of breath, lazy speech, dizziness, blurred vision, poor appetite, loose stool. Pale and enlarged tongue, or with teeth marks, weak pulse.

Treatment & Formulas: Tonify the spleen and stomach so as to ascend the middle Qi.

Bu Zhong Yi Qi Tang (Ginseng and Astragalus Combination, Item No. 2225): This is a typical formula for any kind of prolapse which is due to the Qi deficiency.

2. Rectal Prolapse due to the Deficiency of Spleen and Kidney:

Indications: Rectal prolapse, heavy and dropping feelings at lower abdomen and around anus, accompanied with fatigue, shortness of breath, dizziness, blurred vision, sore and weak sensation at lumbar region, frequent urination - especially at night, constipation, pale tongue, thready and weak pulse.

Treatment & Formulas: Tonify the spleen and kidney.



Ba Wei Di Huang Wan (Rehmannia Eight Formula, Item No. 2011): A tonic used for both kidney Yin and Yang.

Liu Wei Di Huang Wan (Rehmannia Six Formula, Item No. 2051): It is a tonic for kidney yin.

Shi Quan Da Bu Tang (Ginseng and Tang - Kuei Ten Combination, Item No. 2015): It is a general tonic formula for the spleen. It can be combined the with above formulas.

3. Rectal Prolapse due to the descending of Damp - Heat:

Indication: Rectal prolapse through the anterior wall of the rectum, burning sensation around anus, pain and swollen, accompanied with flush face, general hot feeling, thirsty and foul breath, suffocating and fullness of chest, epigastric region, or abdomen, constipation, scanty yellow urine, red tongue, yellow greasy tongue coating, deep, thready and rapid pulse.

Treatment & Formulas: Clear heat and eliminate the damp factor.

Long Dan Xie Gan Tang (Gentiana Combination, Item No. 2267): It is a very effective formula for damp-heat at liver, gall bladder, or intestines.

Yi Zhi Tang (Cimicifuga Combination, Item No. 2001): It treats rectal prolapse, hemorrhoids and constipation due to the damp heat.

Shan Huang Xie Xin Tang (Coptis and Rhubarb Combination, Item No. 2026): One with rectal prolapse with strong interior heat can chose this formula, or combine with other formulas.