Our Summary

This research paper looks at the effectiveness of a treatment called sclerotherapy in treating rectal prolapse in children. Rectal prolapse is a condition where the rectum, the end part of the large intestine, slips outside the anus. Sclerotherapy is a procedure that involves injecting a solution directly into the affected area to shrink it.

The researchers reviewed 19 studies published between 1970 and 2017, which involved a total of 1510 children with an average age of 4.5 years. Most of these children did not have any other health conditions.

Two main types of solutions were used in these treatments: ethanol (alcohol) and phenol. On average, each child received about one treatment.

The results showed that after just one treatment, the condition improved in about 77% of the patients. The complication rate was about 14%, which is relatively low.

The paper concludes that sclerotherapy is an effective and low-risk treatment for rectal prolapse in children and should be considered before opting for more invasive surgical options. However, the researchers also note that the quality of the existing studies on this topic is not very high, indicating the need for further, more rigorous studies.

FAQs

  1. What is sclerotherapy and how is it used to treat rectal prolapse in children?
  2. What were the results of the research on the effectiveness of sclerotherapy in treating rectal prolapse in children?
  3. Why do the researchers suggest that sclerotherapy should be considered before more invasive surgical options for rectal prolapse in children?

Doctor’s Tip

A doctor may advise a patient undergoing rectal prolapse surgery to follow post-operative care instructions closely, including taking prescribed medications, avoiding heavy lifting, and maintaining a high-fiber diet to prevent constipation. They may also recommend pelvic floor exercises to strengthen the muscles in the area and reduce the risk of recurrence. Regular follow-up appointments with the doctor will also be important to monitor healing and address any concerns.

Suitable For

Rectal prolapse surgery is typically recommended for patients who have recurrent or severe cases of rectal prolapse that do not respond to conservative treatments such as dietary changes, pelvic floor exercises, or medications. Patients who experience symptoms such as chronic constipation, fecal incontinence, or rectal bleeding may also be candidates for rectal prolapse surgery.

In some cases, rectal prolapse surgery may be recommended for pediatric patients who have not responded to other treatments and continue to experience significant symptoms. However, as the research paper mentioned above suggests, sclerotherapy may be a viable alternative for children with rectal prolapse, especially if they have not yet undergone surgery or have only mild to moderate symptoms.

Ultimately, the decision to recommend rectal prolapse surgery will depend on the individual patient’s symptoms, medical history, and overall health. It is important for patients to discuss their treatment options with a healthcare provider to determine the best course of action for their specific situation.

Timeline

Before rectal prolapse surgery, a patient may experience symptoms such as rectal bleeding, pain, a feeling of a bulge or protrusion from the anus, and difficulty controlling bowel movements. They may undergo diagnostic tests such as a physical examination, colonoscopy, or imaging tests to confirm the diagnosis.

After rectal prolapse surgery, the patient may experience pain and discomfort at the surgical site, as well as temporary changes in bowel habits. They will need to follow post-operative instructions provided by their healthcare provider, which may include dietary restrictions, pain management, and wound care. The patient will also have follow-up appointments to monitor their recovery and ensure the success of the surgery. In the case of sclerotherapy, the patient may experience improvement in their symptoms after just one treatment, with a relatively low rate of complications.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with rectal prolapse surgery?

  2. How long is the recovery process after rectal prolapse surgery?

  3. Are there any alternative treatments to rectal prolapse surgery, such as sclerotherapy, that I should consider?

  4. What is the success rate of sclerotherapy in treating rectal prolapse compared to surgery?

  5. What are the long-term outcomes of sclerotherapy for rectal prolapse in children?

  6. How many treatments of sclerotherapy are typically needed to see improvement in rectal prolapse?

  7. What are the potential side effects of sclerotherapy for rectal prolapse in children?

  8. Are there any restrictions or lifestyle changes I need to make after undergoing sclerotherapy for rectal prolapse?

  9. How experienced are you in performing sclerotherapy for rectal prolapse in children?

  10. Are there any specific factors about my child’s condition that make them a good or poor candidate for sclerotherapy for rectal prolapse?

Reference

Authors: Hintz GC, Zou VZ, Baird R. Journal: J Pediatr Surg. 2019 May;54(5):1083-1088. doi: 10.1016/j.jpedsurg.2019.01.033. Epub 2019 Feb 3. PMID: 30782440