Question

A 65 year old woman presents with anorectal discomfort. She says that she has trouble initiating defecation. In addition, she feels a protrusion from her rectum when she is finished moving her bowels. On exam, a patulous anus and rectal prolapse are evident. How do you mange this?

Answer 1

Management for an elderly woman with rectal prolapse may start with conservative measures such as dietary changes and pelvic floor strengthening or may require surgical intervention if the prolapse is severe, potentially including rectopexy, a new fecal pouch, or ileostomy.

Step-by-step explanation:

The management for a 65-year-old woman presenting with anorectal discomfort, trouble initiating defecation, and rectal prolapse involves several potential strategies. Rectal prolapse occurs when the rectum becomes detached and protrudes from the anus. The initial step is often conservative management, including stool softeners, dietary fiber, and physical therapy to strengthen the pelvic floor muscles. If these measures are ineffective or the prolapse is severe, surgical repair may be necessary. Resection of the prolapse and rectopexy or a procedure to secure the rectum to the sacral bone can be performed. An alternative surgical method includes the creation of a new fecal pouch from the small intestine, which is then sutured to the anus. If this is not possible, an ileostomy may be required.