How can you tear your rectum. Ruptures of the rectum: causes, symptoms, diagnostic tests and treatment. Treatment of anal sphincter insufficiency

The rectum is the final section of the human digestive system. Its length is about 15-18 centimeters.

This is a muscular intestine, which consists of two layers of muscles - internal and external. In the middle it is covered with a mucous membrane.

On it are longitudinal folds, in the amount of 7-10 pieces. They greatly help the intestines to function properly.

The function of the rectum is to accumulate fecal matter, and their excretion into the environment. It ends with a sphincter, or anus.

When enough feces accumulate, they irritate the sphincter, and the person feels the need to go to the toilet.

Rectal injuries are rare. But all of them carry a great danger to the body.

Injuries of the large intestine

Injuries to the rectum occur with strong blows to the abdomen. This happens during accidents, explosions, falls from a great height, under the influence of great pressure on a person.

The intestine is injured in this case in completely different ways. You can just press it hard, or you can get a gap.

When a large blow is directed perpendicular to the person's abdomen, a complete detachment of the rectum is likely to occur. This is very dangerous and fraught with great complications.

There is also a great difficulty in diagnosing such injuries, since, under the influence of great force, multiple injuries occur.

Traumatic injuries also occur with gunshot, cut-stab wounds of the abdominal cavity.

All injuries and injuries are treated exclusively by surgery.

Factors

The causes of such an injury are many factors that affect the body.

All these factors are divided into:

• external;
• internal.

• gunshot wounds;
• stab wounds;
• damage by medical instruments;
• the occurrence of injuries under the influence of blows of great force;
• intestinal ruptures with the introduction of air flow;
• injuries from falling on sharp objects;
• falling on the perineum;
• a great opportunity to severely injure the rectum with fractures of the pelvic bones.

Internal factors include:

• greatly increased internal abdominal pressure, which is much higher than normal;
• complications during childbirth in women;
• great difficulty in passing bowel movements, severe and frequent constipation;
• great physical activity;
• the presence of hemorrhoids;
• sphincter damage;
• anatomical structure and features of the body;
• the presence of a foreign body in the stool.

Classification

All defects are divided into:

• simple;
• complications that are caused by violations of the sphincter;
• complications that are caused due to disruption of the functioning of other internal organs of a person.

The complexity of injury is determined by the amount of damage. They are classified according to location. There are injuries that are localized in the abdominal cavity, and outside the abdominal cavity.

All injuries resulting from medical manipulations are classified into:

• light damage. These include anal fissures, small tears in the rectal mucosa. Such damage is treated with drugs that are characterized by local effects. They heal in a few days;
• medium damage. Stratification of the rectum or other intestines into the extraperitoneal cavity, various damage to the intestine without violating the integrity of the abdominal muscles;
• heavy damage. Damage to the integrity of the abdominal cavity, or other organs, initiating infection processes, complications.

Symptoms

Any damage to the large intestine carries with it pronounced symptoms:

• the presence of blood in the feces;
• severe and sharp pain in the area of ​​​​damage;
• purulent discharge;
• urge to defecate, mostly of a false nature;
• a strong inflammatory or infectious process progresses;
• uncontrolled and spontaneous excretion of feces, due to a violation of the integrity of the wall;
• development of acute peritonitis.

The presence of any of the symptoms is a direct indicator for an urgent visit to a specialist.

A rectal injury has special signs by which doctors can accurately determine the diagnosis and provide the necessary assistance:

• a strong increase in the patient's pulse - tachycardia above 100 beats per minute;
• hypotension is a critical decrease in blood pressure. The tonometer readings fluctuate within 90/60;
• due to severe pain, the patient can take a comfortable fetal position for him, lying on one he bends his legs under him;
• sometimes, in severe cases, the person is unconscious;
• the anterior abdominal wall is strongly strained;
• a vivid expression of the Shchetkin-Blumberg symptom. When pressing on the abdomen with the fingers of one hand, the patient feels pain. With a sharp removal of the hand, the pain increases sharply;
• using the method of digital examination, blood, feces are found in the rectum;
• in the patient, gases and feces are involuntarily released.

Diagnostics

The fastest, simplest and most reliable diagnostic method is palpation of the rectum.

This method consists in the fact that the doctor probes the anus and rectum with the index finger of the hand and detects damage.

The method is available in any situation and gives an accurate understanding of the location, size, shape, nature of damage.

Also, the following diagnostic methods are no less effective, but longer:

• examinations using a special rectal mirror;
• anoscopy. An anoscope - an apparatus for carrying out the procedure, is inserted into the anus, it slightly expands the intestine and allows the doctor to see the damage;
• ultrasound examination of the abdominal cavity. Ultrasound makes it possible to examine the entire abdominal cavity, to detect possible additional injuries of the digestive tract;
• radiograph. The image will show the lesions, their location and complications;
• sigmoidoscopy. The device for this procedure is a tube that supplies air and allows you to expand the intestine. The doctor can visually assess the severity of the patient.

The specialist himself determines the method of diagnosis. It depends on the severity of the patient, on the causes of its occurrence and vivid symptoms.

Treatment

Injury to the intestines, rectum, regardless of location, shape and size, when a patient enters a medical institution, is treated with surgical methods. In other words, a surgical operation is performed.

The damage is sutured with special threads, which then dissolve on their own, the stitches will not need to be removed.

Specialists are doing everything to restore as many tissues as possible and preserve the walls of the intestines as little as possible.

In severe cases, surgeons use a special mesh or gauze that they sew into the walls of the rectum. This is done in cases where the damage is very large, a serious rupture has occurred, and there is no way to fix all the muscular structure of the intestine.

Such gauze is treated with a special medicinal antiseptic. It takes root perfectly and its presence is not reflected in any way on human health.

The postoperative period is long and difficult.

With simple and, sometimes, moderate injuries, conservative treatment is possible.

Diet

A person needs to stick to a diet so as not to severely injure the intestine. His diet should consist of liquid, light food. All products should be quickly absorbed and be characterized by good hatchability.

It is necessary to monitor the acts of defecation, they should be at least once every 48 hours.

All food should be warm, you need to eat in portions, no more than 200 grams per meal. It is worth eating 7-8 times a day.

In the postoperative period is strictly prohibited:

• peas, beans, lentils;
• any carbonated drinks;
• alcohol;
• bakery products;
• flour products (dumplings, pizza, dumplings, pies);
• rice, semolina;
• foods that cause gas formation processes in the intestines (cabbage, corn);
• fatty, fried foods;
• meat (chicken, rabbit are allowed);
• any smoked meats;
• spicy food and any strong seasonings.

The patient is contraindicated in a hot bath, physical activity, stress, anxiety. All this will adversely affect recovery and delay the rehabilitation period.

It is important to observe bed rest, exclude all physical activity and follow all the instructions of the attending physician.

ethnoscience

You can apply and recipes of traditional medicine. Sometimes decoctions of herbs are used, which weaken. So you can control the filling of the intestine and prevent stagnation of fecal masses.

To quickly establish the functioning of the intestines and rectum, you can drink decoctions from chamomile, mint, nettle, rosehip, mint.

These herbs are antibacterial and healing. Such decoctions should be drunk without sugar, honey and other additives. All of them destroy the healing properties of the infusion.

Laxatives:

• flax-seed. One tablespoon of seeds pour 250 ml of hot water, leave for 8-10 hours. After strain and drink in the morning. Steam for the night;
• Castor oil. One tablespoon of oil and honey is mixed, egg yolk is added. Here you can still have a little water, bring to the consistency of thick sour cream. Take 2-3 tablespoons throughout the day.

The patient must strictly comply with the following recommendations:

• several times a day to carry out special enemas;
• drink all the medicines prescribed by the doctor (antibiotics, anti-inflammatory and antibacterial). It can be ointments, suppositories, tablets, syrups, creams;
• dietary compliance. The doctor will prescribe individual nutrition, taking into account all the features of the patient's disease;
• sanitation of the abdominal cavity;
• you need to use, inside, the recommended essential oils;
• after suturing the damage, bed rest can last for 10-12 weeks, or even much more.

Diseases and damage to the rectum is very dangerous and threatens with great trouble.

Here you just need to contact a doctor in order to receive highly qualified medical care, and you will forever lose this problem.

If these symptoms have been observed for some time, then you should definitely contact doctor- proctologist, since the disease itself, although it does not pose an immediate threat to life, can lead to disability and the inability for a person to be in society.

This warning is relevant for the reason that patients, noticing certain symptoms in themselves, or even their combination, nevertheless delay a visit to a specialist, since they consider the problem to be very delicate. However, it should be remembered that when it comes to health, there is nothing to be ashamed of - you need to be treated as soon as possible, without delaying or aggravating the situation.

How anal sphincters work

The internal and external anal sphincters provide tonic and volitional retention of anal contents, but the violation of these functions leads to incontinence of the contents of the rectum. Moreover, if the work of the external sphincter is disrupted, then a person, at the time of filling the rectum, while maintaining the urge to defecate, cannot retain the intestinal contents. If the work of the internal sphincter is disturbed, incontinence also occurs during sleep or at moments of emotional stress.

Types of traumatic disorders

Violations of the anal sphincter are possible due to non-traumatic disorders of the obturator apparatus and due to traumatic injuries of the anal sphincter. Most often, traumatic muscle injuries occur after operations on the rectum and perineum, with ruptures of the perineum during childbirth in women, injuries such as "falling on a stake", as a result of the forcible introduction of objects into the rectum, due to car accidents and gunshot wounds.

Features of post-traumatic insufficiency of the anal sphincter

In most cases, with the traumatic nature of incontinence, there is a decrease in tonic and voluntary pressure in the region of the external sphincter. Also, the disease is characterized by the fact that, in addition to a purely local problem, against its background, the development of certain diseases of neighboring organs, and primarily the genitourinary system and pelvic bones, often begins. In addition, damage to the muscular apparatus of the anal sphincter is aggravated by the cicatricial process due to the current suppurative process.

Degrees of the disease and complications

There are three degrees of clinical manifestation of anal sphincter insufficiency. The emerging problem with the retention of gases should be alert - this first the degree of the disease. At second degree, the patient adds another symptom - loose stool incontinence, but with third degrees, all elements of the intestinal contents are no longer retained in the intestines.

As already mentioned, traumatic injuries of the anal sphincter are often accompanied by disruptions in the functioning of neighboring organs, and in a complicated form, insufficiency of the anal sphincter is often combined with rectovaginal fistulas, chronic, strictures of the anal canal.

Questions from readers

October 18, 2013, 17:25 After an extensive operation to remove hemorrhoids, the doctor advises not to eat anything for as long as possible (only broth and uzvar) in order to avoid the release of calla masses and the sutures heal better. A week after the operation, I lost a lot of weight. Other doctors recommend eating as early as the second day (diet) and achieving regular soft stools daily. Before the operation, he did not suffer from constipation. Whom to listen to?

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Diagnostic methods

If traumatic injuries of the anal sphincter are suspected, when taking an anamnesis, the doctor first of all pays attention to such patient complaints as gas and fecal incontinence. This is followed by an examination of the patient, which is carried out on a gynecological chair. It is necessary to assess the condition of the anus, the condition of the skin in this area, the presence of deformation of the anus and perineum.

By means of a digital examination of the rectum, the presence and extent of the cicatricial process, its distribution within the anal canal (wall), the condition of the muscles of the pelvic floor, as well as the elasticity and length of the sphincter, are ascertained.

Also, at the present stage, to diagnose traumatic injuries of the anal sphincter, such diagnostic methods are used as:

• anoscopy (visual examination of the walls of the anal canal and the distal rectum);
• proctography (find out the relief of the mucous membrane of the rectum, the state of the pelvic floor, the size of the anorectal angle);
• sigmoidoscopy (examination of the rectal mucosa and distal sigmoid colon);
• irrigoscopy with double contrast (assess the condition of the colon, allows you to identify the presence of narrowed and expanded areas, fecal stones).

Treatment

In the treatment of traumatic damage to the anal sphincter, an integrated approach is required.

The decision on the need for surgical intervention is made by the doctor in many scenarios, but there is an important contraindication here - the presence of damage to the central and peripheral nervous system.

Conservative treatment is indicated in almost every case. As a rule, this is a complex of drug therapy, electrical stimulation of the muscles of the anal sphincter, physiotherapy exercises.

It should be noted that even in the most severe and advanced cases, the use of a systematic integrated approach guarantees a favorable outcome and almost complete recovery.

The risk of rectal rupture on rectal palpation in horses has been documented in many cases, and yet for equine veterinarians, bleeding from the rectum is always unexpected. In fact, rectal rupture can occur with any rectal palpation, regardless of the experience of the veterinarian and the conditions under which it is performed. However, carelessness during the treatment of tears does more harm than the tear itself. Therefore, veterinarians must know exactly what to do when the rectum ruptures.

RESPONSIBILITY

According to the American Veterinary Medical Association's (AVMA) Professional Liability Insurance Fund, about 7% of complications from rectal ruptures result from careless treatment of animals. However, veterinarians should not inform clients of the dangers of rectal palpation and generally do not require written consent from owners before performing rectal palpation. However, explaining the risks and consequences of rectal palpation may protect the veterinarian from liability. Before examining a horse, a one-page information sheet should be given to the owner or information packs should be distributed to new clients. For some horses, rectal palpation is too risky. For example, 11.7% of rectal lesions reported by the AVMA Responsibility Fund between 1979 and 1994 Observed in Arabian horses, and most of them were young horses (aged 1 to 5 years) and stallions. Young stallions, especially Arabian ones, have an increased risk of rectal injury.
Regardless of the type of written consent, veterinarians should not be careless in the event of a rectal rupture, despite the precautions they have taken against rectal injury. Such precautions include adequate restraint of the horse and/or the use of sedatives, lubricants, and the use of brute force by the physician. The degree of fixation depends on the situation and the responsibility lies with the veterinarian performing the procedure. If there is a fixing machine, it must be used. In his absence, the specialist veterinarian should fix the horse with available means and, if necessary, use sedatives or spin.

INITIAL MEASURES AND CARE

In each case of the appearance of blood during palpation of the rectum, organized measures must be taken. First, the owner of the animal should be informed before further manipulations with the horse. After this, the horse should be sedated (eg, xylazine 0.3-0.5 mg/kg qw) and the rectum itself examined. It is best to palpate the rectal mucosa without a rectal sleeve, using a sufficient amount of lubricant. Although practitioners fear worsening the tear during further examination, fingertip palpation of the rectal mucosa will not increase pressure or strain on the tear. The rectum can also be viewed with an endoscope after rectal air insufflation or with a transparent dilator
The purpose of such studies is to determine the degree of rectal rupture (Table 3.20-1) Tears of the 1st degree are superficial tears as a result of friction of the rectal mucosa: they are difficult to detect by touch with the fingers due to the lack of pronounced defects, but they are clearly visible when endoscopic examination (Fig. 3.20-1). Such tears can be treated at the horse farm without sending the animal to a specialized clinic, unless it is a severe tear. Grade 2 tears are perhaps the least common type of rectal tear and are not easily detected due to the absence of rectal bleeding, which usually indicates the need for further investigation. A grade 2 tear is a blockage of the rectum resulting from the formation of a rectal diverticulum. Grade 3 ruptures involving the weight of the rectal layer and walls, with the exception of the serosa or mesentery (see Table 3.20-1), horses should be sent to special clinics for further medical and surgical treatment. Horses with grade 4 tears are euthanized in many cases. However, if the gap is not very large, it may be suggested to send the animal to a clinic. The distance from the anus to the rupture is important, because in adult horses the distance from the peritoneal cavity to the anus is 15-20 cm. The average distance from the anus to the rectal rupture is 30-40 cm, which involves the abdominal cavity. With such localization, the gap is really located within the small colon. Rectal ruptures are most commonly located dorsally, possibly because the mesenteric vasculature intrudes into the intestinal musculature at this site, and the small colon deviates ventrally from the rectum.

CONTACT WITH CUSTOMERS

Immediately after determining the extent of the gap, an initial conversation with the owner about the nature of the problem and an explanation of what needs to be done to treat the horse is carried out. This step is especially important for severe rectal tears (grades 3 and 4). The most difficult part of this conversation is informing clients that medical and surgical treatment of rectal rupture depends on their financial capabilities. It should not be assumed that the veterinarian will admit his fault or will bear the cost of treatment. It is also necessary to notify the insurance agent as soon as possible about the incident. At the same time, one should not think that the insurance company will pay all medical expenses, since such a decision is possible only with the initiation of a lawsuit and evidence of the doctor's negligence. In the vast majority of cases, negligence cannot be proven. A veterinarian in a specialized clinic himself starts a conversation with the client, explaining to him the possible treatment options, their cost and the client's responsibility for paying for medical services.

EMERGENCY TREATMENT FOR RECTAL LEAVES

The feces are completely removed from the rectum. This procedure is performed under epidural anesthesia, which is done in cases where the doctor is worried that the horse will strain. Grade 1 rectal tears usually resolve with nonsurgical medical treatment, including broad-spectrum antibiotics (sulfonamide plus trimethoprim, 20 mg/kg orally every 12 hours) and flunixin meglumine (1.1 mg/kg i.v.). or orally every 12 hours). Horses are given a laxative food, such as bran mash, and closely monitored for signs of progressive rupture, including colic and endotoxemia. For grade 3 or 4 rupture, horses are given intravenous broad-spectrum antibiotics (penicillin and gentamicin, flunixin meglumine, and tetanus toxoid) and should be sent to a specialist clinic as soon as possible. the clinic should take less than 6 hours, which will increase the horse's chances of recovery.
There is some controversy over whether the rectum should be packed prior to admission to the clinic to prevent the stool from widening the rectal tear. This procedure consists of filling the rectum with a tissue bag filled with gauze or rolled cotton from an area cranial to the tear behind the anus. This procedure requires anesthesia. Since many tears are more than 30 cm long proximal to the anus, this procedure is quite time consuming. Therefore, it is necessary to quickly transport the horse if the clinic is located at a considerable distance (3-4 hours of travel). Rectal "wrapping" is performed on horses that will be left untreated for a long time, as the owner needs a considerable amount of time to make a decision.
Although grade 4 tears are almost always fatal, these horses are referred to the clinic for re-diagnosis and treatment as needed. Some grade 4 tears within 15 cm of the anus are not intra-abdominal and can be successfully treated. Horses with grade 4 rectal tears within the abdomen are euthanized. Laparocentesis helps horses with stage 3 and 4 rectal tears to document the extent of abdominal inflammation and infection. Expected findings are cloudy peritoneal fluid, elevated protein (>2.5 g/dl), increased cell count (>10,000 nucleated cells/µl), and intracellular or extracellular bacteria, depending on the extent and extent of the rupture. Such pathological changes usually occur within 1 hour after the resulting lesion.

TREATMENT OPTIONS FOR SEVERE RECTAL TOURS

Before sending an animal with a severe rectal tear to a specialized clinic for treatment, it is helpful to discuss the various treatment options with the owner. One of the simplest treatments for rectal tears is to remove the contents of the rectum every 1-2 hours for 72 hours so that stool does not accumulate at the site of the rectal lesion. The accumulation of stool causes an increase in the defect and may lead to a transition from a grade 3 to a grade 4 rectal tear. Frequent removal of the contents of the rectum should be performed only in horses with small rectal tears (For severe grade 3 tears, alternative surgical methods are usually required. Direct suturing of the tear either through the rectum or by laparotomy (to access the small colon) is usually prevented by localization a tear that is usually out of reach, regardless of the method of suturing.However, sometimes suturing is possible if the tear is located near the anus.In addition, partial suturing of large rectal tears is carried out in combination with other treatments, such as faecal diversion by colostomy or rectal pad to speed up the healing of the tear.Rectal pads consist of plastic rectal sleeves with rings cut off and glued by hand.

This procedure requires a mid-linear laparotomy so that the surgeon can penetrate the peritoneum while the ring is inserted into the rectum proximal to the tear. The surgeon places a bypass suture around the annulus to prevent serious tearing if the peripheral suture and sleeve fail. The main complication of this method is the premature loss of the pad (usually within 10-14 days). while the healing of the gap lasts up to 21 days but by secondary intention.
In a loop colostomy, the small intestine is temporarily removed through an incision on the left side; it is desirable that the horse be in a standing position (Figure 3.20-2). This procedure can be performed with the horse lying on its side, but usually the colostomy ruptures during the convalescent period due to contraction of the lateral muscles. If abdominal exploratory surgery is required to investigate colic (which is often the initial cause of rectal palpation), diagnosis is made first, then the horse is taken out of anesthesia and a colostomy is performed in a standing position). After the operation, the gap is examined and washed with an endoscope. The distal colon is flushed through the rectum to remove accumulated mucus. Complications after colostomy include the formation of a peristomal hernia, self-disintegration of the stoma. exfoliation of the stomal mucosa and atrophy of the distal intestine. After granulation of the rupture (usually within 14-21 days), the colostomy is removed. While this method has been successful, the cost and pain remain significant. Other treatment options, such as laparoscopy, are also being explored.

It is not always possible to quickly establish damage to the rectal mucosa. This is difficult even in cases where the defect is localized within the finger reach. Diagnosis is even more complicated when nearby organs are damaged. An exception can be considered only ruptures of the perineum during childbirth. In addition to determining the clinical signs that help to establish damage to the rectum, it is necessary to conduct a thorough examination and only then prescribe the appropriate treatment for the situation.

Before starting treatment, a perineal examination, rectoscopy, a plain abdominal x-ray to detect free gas, or a study with a coloring contrast agent should be performed. It is also mandatory to conduct a study of the genitourinary organs, sometimes (with extensive damage) it is required to examine the pelvic bones. Damage to the rectal mucosa is easily recognized only with a bright clinical picture (a large wound in the perineum or peritonitis) or with a prolapse of small bowel loops.

Treatment for extra-abdominal injury

Damage to the wall and mucous membrane of the anal canal is always subject to primary surgical treatment and drainage of the wound. It is important to ensure the regulation of the stool: you can temporarily delay the stool by taking norsulfazole 1 g three times a day and ascorbic acid along with a slag-free diet. If more than a day has passed after the injury and there are strongly pronounced signs of inflammation of the surrounding tissues, then after the initial therapeutic and surgical treatment, the wound is not sutured. In the presence of a more active inflammatory process, as well as signs of intoxication, an urgent colostomy is required. After 3-4 months, after the complete elimination of the purulent-inflammatory process, one of the plastic surgeries is performed, which is used in the treatment of insufficiency of the anal sphincter muscles.

When diagnosing extraperitoneal damage to the rectal mucosa, limited only to the mucous membrane itself and a thin muscle layer, without leakage of intestinal contents into the pararectal tissue, treatment should begin with conservative measures. Usually these are measures to delay stool for 5-6 days, microclysters containing antiseptic solutions. Close monitoring of the patient is necessary. If the spread of the inflammatory process continues, then it may be necessary to apply a sigmostoma with drainage of pararectal tissue, as well as its irrigation with antiseptic solutions.

If the entire surface of the rectal mucosa is damaged, surgical treatment of the wound is performed by perineal access. The intestinal wall is sutured with double-row sutures, pararectal tissue is drained, microirrigators are introduced to irrigate the affected surface of pararectal tissue. A prerequisite for this is the imposition of a colostomy, which is closed 1.5 months after a thorough examination of the patient and with the complete exclusion of internal fistulas.

Treatment for intra-abdominal injury

With intra-abdominal damage to the rectal mucosa, an urgent laparotomy is required. The abdominal cavity is opened by a lower median approach, a thorough revision is performed. The abdominal cavity and the loops of the small intestine that have fallen into the rectum are sanitized with an isotonic sodium chloride solution with an antiseptic. All defects of the rectal wall are sutured with a double-row suture, a sigmostoma is applied. A prerequisite is to ensure drainage of the entire abdominal cavity and the introduction of special micro-irrigators. Subsequent postoperative management is the same as that used in patients with peritonitis.

In case of parallel damage to the bladder, immediately after suturing the gap, a cystostomy is applied. In cases of injury to the bladder during the operation on the rectum, this defect is sutured, while the cystostomy can not be applied, but the urine can be evacuated with a self-retaining catheter.

In the case when there is damage to the rectal mucosa by a foreign body and the patient is delivered with it, after taking all measures to ensure the possibility of surgical intervention, the foreign body is removed. With intra-abdominal damage to the rectal mucosa, the prognosis for recovery worsens as the period from the moment of injury to the receipt of medical care increases. Even with the most optimal timing, deaths are not uncommon - in 30-50% of cases.

Very often, during the next act of defecation, a person may feel severe pain, discomfort and burning sensation in the anus. There can be many reasons for this. Among them, a disease such as rectal sphincteritis (inflammation of its membranes) is distinguished.

In proctology, this is a common disease that is not life-threatening for the patient, but if not treated in time, it can cause many unpleasant pathologies. Therefore, it is very important at the first unpleasant symptoms to consult a specialist who will prescribe an effective treatment. In the article we will consider what is rectal sphincteritis, symptoms, treatment of this disease.

There are about 35 sphincters in the entire human digestive system. What is it? These are special muscle valves that perform a locking function in the human body.. It is thanks to them that food moves throughout the body, smoothly moving from one organ to another.

rectum

Among the many sphincters, let's take a closer look at the anal one. This valve is responsible for the movement of feces through the rectum and is responsible for the processes of emptying. Has two parts:

Sphincter diseases

The most common diseases of the rectal sphincter are: spasm and sphincteritis. A photo of inflammation of the sphincter of the rectum can be seen below.

In the first case, this is a chronic form of the disease, in which a person observes constant pain and discomfort in the anus. This disease develops for quite a long time and causes severe discomfort for the patient's life. Therefore, it is recommended not to delay the treatment of this problem.

Sphincteritis is an inflammatory process in which its muscles become inflamed. This disease is characterized by a wave-like exacerbation, treatment proceeds for a long period of time. Below is a photo of rectal sphincteritis.

What is rectal sphincteritis

This disease is one of the most common in proctology. Sphincteritis is an inflammation of the sphincter muscles. In this case, there is a violation of the full-fledged work of the latter, and with untimely treatment, the patient can delay the process to severe complications. When the sphincteritis is running, the muscles completely relax and the patient loses the ability to retain feces and gases in the body, so an unexpected act of defecation can occur.

This is a rather delicate problem, so it is recommended to treat it in time. The development of the disease occurs as follows: in the presence of wounds or cracks in the anus, pathogens can get there, they begin to actively multiply and provoke the formation of purulent masses. Next, inflammation of the affected area occurs and acute unpleasant symptoms of sphincteritis appear.

Causes of the disease

Oddly enough, there are many causes of sphincteritis. The development of inflammation of the sphincter muscles can contribute to, or other pathologies.

Independent development of sphincteritis is impossible, it is the result of other diseases in the anal area.

Among other factors that can provoke the development of inflammation of the sphincter muscles can be identified:

• infections of the anus of a bacterial nature;
• violations of the digestive tract;
• spicy food;
• tumor formations in the rectum;
• trauma to the anus during anal sex;
• frequent spastic constipation (when firmly formed feces pass through the sphincter, the muscles of which are in good shape);
• bowel disorders that cause severe irritation of the mucous membrane of the anus

Main symptoms

The characteristic signs of inflammation of the anal sphincter are:

• itching and burning in the anus;
• bloating and discomfort;
• stool disorder in the form of persistent diarrhea or constipation;
• sharp pain during the act of defecation;
• lower abdominal pain;
• loss of appetite, insomnia;
• pain symptoms in the lower back or coccygeal region;
• frequent urge to empty, often they are false;
• mucous or spotting in the stool;
• high body temperature;
• nausea, vomiting, severe malaise.

It is important to note that the main symptoms will be directly related to the concomitant proctological disease. Therefore, if any of the unpleasant symptoms appear, you should immediately see a doctor.

Damage to the sphincter in a woman can occur during childbirth. It is then that may appear and, which give impetus to the start of the inflammatory process of the anal sphincter. How to understand that the rectal sphincter is damaged in women? It is impossible to do this on your own from the photo, an examination by a specialist is required.

Methods of treatment

First of all, to clarify the diagnosis, you need to undergo a comprehensive diagnosis, which includes:

• examination of the patient by a proctologist by palpation;
• blood tests for biochemical, immunological and cytological parameters;
• stool analysis;
• rectoscopy of the anus.

Only after receiving all the results, the doctor can establish the form of the disease and prescribe an effective treatment.

Treatment with suppositories of symptoms of rectal sphincteritis is carried out in acute forms of the disease. use rectal suppositories such as Posterisan, Proctoglivenol or others. They quickly help relieve pain and heal the affected areas.

How to relax the sphincter? To do this, use a special blockade, which includes the removal of pain and relaxation of the muscle muscles of the sphincter.

Thanks to this procedure, the process of natural emptying is simplified for the patient. It is performed as follows: a syringe with an anesthetic is injected into the anus and the anus is closed with a swab with glucosteroid ointment. The tampon is in the anus until the first urge to defecate.

Also, the treatment of sphincteritis is carried out with various creams, ointments for rectal administration.. The course depends on the form and degree of the disease, is selected by the doctor individually.

In some cases, complex comorbidities may require surgery followed by antibiotics.

A prerequisite for improving the effectiveness of treatment is following a strict diet and moderate exercise. An example is "Proctosan", "Bezornil", "", "Heparin ointment", etc.

A very popular treatment for inflammation in the sphincter is sphincterotomy. This operation is performed under general anesthesia. The doctor removes a small area of ​​the skin on the anus and cuts the sphincter a little. This helps the muscles to relax and adjust the process of natural emptying.

Conclusion

Sphincteritis of the rectum is a very common disease. It occurs against the background of already existing injuries or diseases of the rectum. May have an acute or chronic manifestation. In most cases, topical drug treatment is used and a strict diet is prescribed for the patient.

In some cases, with complicated forms of sphincteritis, surgical intervention is performed. To prevent the disease, you need to monitor your diet and health, regularly visit a proctologist for examinations.