Anal Longitudinal Folds Prolapse refers to a condition where the inner lining of the anal canal (which has longitudinal folds) begins to slide or prolapse outside of the anus. This condition can cause discomfort, embarrassment, and a range of symptoms that impact daily life.
In this guide, we will break down all aspects of this condition, including its structure, causes, symptoms, diagnosis, treatment options, and much more in simple, easy-to-understand language.
Anatomy of the Anal Canal
Structure
The anal canal is the last part of the digestive system, approximately 4 cm long. It is surrounded by muscles and lined with mucosal tissue that forms folds called “longitudinal folds” which help control bowel movements. These folds stretch when we pass stool and contract afterward.
Blood Supply
The anal canal has a rich blood supply from branches of the rectal arteries. Blood flows from the superior, middle, and inferior rectal arteries. Venous drainage follows a similar pattern through rectal veins.
Nerve Supply
The anal region is highly sensitive, with nerve supply mainly coming from the pudendal nerve and other autonomic nerves. These nerves help control the muscles in the area and give us the urge to go to the bathroom.
Types of Anal Prolapse
There are different types of prolapse related to the anus and rectum:
- Rectal Prolapse: The entire rectal wall slips out through the anus.
- Mucosal Prolapse: Only the mucosal layer (the innermost lining) of the rectum slips out.
- Internal Prolapse: The rectum does not protrude outside but collapses inside the body.
- Anal Longitudinal Fold Prolapse: The folds of tissue inside the anal canal start to prolapse out.
Causes of Anal Longitudinal Folds Prolapse
- Chronic constipation
- Chronic diarrhea
- Weak pelvic floor muscles
- Prolonged straining during bowel movements
- Childbirth (vaginal delivery)
- Advanced age
- Heavy lifting
- Coughing frequently (due to chronic lung conditions)
- Neurological diseases (e.g., multiple sclerosis)
- Previous rectal surgery
- Rectal or anal tumors
- Obesity
- Genetic predisposition
- History of pelvic organ prolapse
- Hormonal imbalances
- Rectal trauma
- Excessive use of laxatives
- Rectal infections
- Anorectal malformations
- Radiation therapy to the pelvic area
Common Symptoms of Anal Longitudinal Folds Prolapse
- Visible bulge of tissue from the anus
- Feeling of fullness or pressure in the rectum
- Difficulty controlling bowel movements
- Mucus or blood discharge from the anus
- Itching around the anus
- Discomfort while sitting
- Feeling of incomplete evacuation after bowel movements
- Pain during bowel movements
- Rectal bleeding
- Constipation
- Inability to pass gas easily
- Leakage of stool
- Swelling around the anus
- Chronic irritation or inflammation
- Frequent need to push back the prolapsed tissue
- Bowel incontinence
- A sensation of something “falling out” of the rectum
- Change in stool consistency
- Skin irritation around the anus
- Loss of sensation or numbness in the area
Diagnostic Tests for Anal Longitudinal Folds Prolapse
- Physical Examination: The doctor visually inspects the anus.
- Rectal Examination: A gloved finger checks for abnormalities.
- Anoscopy: A scope is used to view the anus and lower rectum.
- Proctoscopy: A camera is used to examine the rectum.
- Colonoscopy: A full examination of the colon to rule out other causes.
- Defecography: X-rays taken while the patient attempts to defecate.
- MRI Defecography: Imaging to assess pelvic floor function.
- Ultrasound: An internal probe examines the anal sphincter muscles.
- Endoanal Ultrasound: Provides detailed images of the anal canal.
- Pelvic MRI: Scans to assess any underlying pelvic issues.
- Electromyography (EMG): Measures the activity of the pelvic floor muscles.
- Anal Manometry: Tests the strength of anal sphincter muscles.
- Balloon Expulsion Test: Measures the ability to expel a balloon from the rectum.
- Stool Tests: Check for infections or inflammation.
- CT Scan: Cross-sectional imaging of the pelvis.
- Barium Enema: X-rays taken after a barium contrast is introduced into the rectum.
- Nerve Conduction Tests: Evaluate nerve function in the pelvic area.
- Sigmoidoscopy: Examines the rectum and the lower part of the colon.
- Biopsy: Tissue samples may be taken for further analysis.
- Cystoscopy: Sometimes used to rule out other pelvic issues.
Non-Pharmacological Treatments for Anal Longitudinal Folds Prolapse
- Pelvic Floor Exercises: Strengthen the muscles around the anus and rectum.
- Biofeedback Therapy: Trains the patient to control their pelvic muscles.
- Dietary Fiber: Helps to prevent constipation by softening stool.
- Hydration: Drinking enough water can help prevent straining.
- Stool Softeners: These can be recommended to ease bowel movements.
- Avoiding Straining: Being mindful of not pushing too hard during bowel movements.
- Squatting During Bowel Movements: This can reduce pressure on the rectum.
- Reducing Heavy Lifting: Minimizes strain on the pelvic floor.
- Managing Chronic Cough: Treating the underlying cause of a chronic cough.
- Weight Loss: Helps reduce pressure on the pelvic area.
- Use of Supportive Garments: Helps keep prolapsed tissue in place.
- Postural Training: Learning to sit in positions that reduce strain on the anus.
- Probiotic Supplements: Help balance gut flora and improve digestion.
- Regular Bowel Habits: Training the body to have regular bowel movements.
- Warm Sitz Baths: Soothe and relax the anal region.
- Cold Compresses: Reduce swelling and discomfort.
- Kegel Exercises: Strengthen the pelvic floor muscles.
- Yoga: Focuses on poses that strengthen the pelvic floor.
- Acupuncture: May help alleviate pain or discomfort.
- Stress Management: Stress reduction techniques to ease muscle tension.
- Massage Therapy: Can relieve pelvic floor tightness.
- Postural Changes: Learning new techniques for bowel movements.
- Wearing Comfortable Clothing: Helps avoid pressure on the prolapsed area.
- Reducing Time on the Toilet: Minimizes the strain on the rectum.
- Avoiding Laxative Overuse: To prevent dependency and muscle weakening.
- Pacing Activities: Balancing rest and activity to avoid overexertion.
- Use of Cushions: To ease sitting discomfort.
- Manual Reduction: Gently pushing prolapsed tissue back inside.
- Mindful Breathing: Helps relax the body during bowel movements.
- Topical Creams: Natural products like witch hazel to reduce irritation.
Medications for Anal Longitudinal Folds Prolapse
- Laxatives: To help with constipation.
- Stool Softeners: Prevents hard stools and straining.
- Fiber Supplements: Improve stool consistency.
- Topical Corticosteroids: Reduce inflammation and pain.
- Nitroglycerin Ointment: Relieves anal discomfort.
- Botulinum Toxin Injections: Helps relax tight muscles.
- Pain Relievers: Like acetaminophen for pain relief.
- Anti-inflammatory Drugs: To reduce swelling.
- Hemorrhoid Creams: Soothes irritation and swelling.
- Antibiotics: If an infection is present.
- Antidiarrheals: To manage chronic diarrhea.
- Probiotics: Promote healthy digestion.
- Anticholinergic Medications: Help control bowel movements.
- Sitz Bath Solutions: Medicinal soaks for the anal area.
- Muscle Relaxants: To ease rectal muscle tension.
- Local Anesthetics: To relieve pain during bowel movements.
- Topical Lidocaine: Numbs the anal area for pain relief.
- Glyceryl Trinitrate Ointment: Relieves sphincter pressure.
- Benzocaine Ointment: Provides temporary pain relief.
- Psyllium Supplements: Help bulk up stool for easier passage.
Surgeries for Anal Longitudinal Folds Prolapse
- Rectopexy: Secures the rectum back in place.
- Delorme’s Procedure: Removes excess tissue and tightens the muscles.
- Perineal Rectosigmoidectomy: Removes the prolapsed part of the rectum.
- Laparoscopic Rectopexy: A minimally invasive version of rectopexy.
- Altemeier Procedure: Perineal surgery to remove prolapsed tissue.
- Stapled Transanal Rectal Resection (STARR): For internal rectal prolapse.
- Anal Sphincter Repair: If the sphincter muscles are weakened.
- Hemorrhoidopexy: Lifting and securing the prolapsed tissue.
- Transanal Excision: Removal of prolapsed tissue via the anus.
- Pelvic Floor Reconstruction: To strengthen the overall support.
Prevention Tips for Anal Longitudinal Folds Prolapse
- Eat a Fiber-Rich Diet: Helps keep bowel movements regular.
- Stay Hydrated: Drinking enough water prevents constipation.
- Exercise Regularly: Helps strengthen the pelvic floor.
- Avoid Straining: Don’t push too hard during bowel movements.
- Manage Weight: Maintaining a healthy weight reduces pressure on the pelvic area.
- Lift Properly: Use your legs rather than your back when lifting heavy objects.
- Treat Coughing Early: Address chronic coughing to prevent strain.
- Use the Bathroom When Needed: Don’t hold in bowel movements.
- Do Pelvic Floor Exercises: Keep the muscles strong and supportive.
- Avoid Prolonged Sitting: Take breaks to reduce pressure on the rectum.
When to See a Doctor
- If you experience persistent rectal bleeding
- If the prolapse worsens or cannot be pushed back in
- If you have severe pain or discomfort
- If you notice a change in bowel habits that lasts more than a few weeks
- If you develop incontinence or difficulty controlling bowel movements
- If you notice any unusual lumps, growths, or hard areas
- If the prolapse interferes with daily activities or causes embarrassment
Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.