Our Summary

This research paper investigates whether tricyclic antidepressants (TCAs) can help improve a condition known as tenesmus in patients with rectal prolapse. Tenesmus is the feeling of constantly needing to pass stools, even when the bowels are empty. It can lead to straining and worsening of the rectal prolapse, a condition where the rectum, the final section of the large intestine, comes out of the anus.

The study reviews the cases of 23 patients, with an average age of 75.3 years, who had severe tenesmus and were either not suitable for surgery or had refused it. They were treated with low doses of TCAs. After an average follow-up period of 9.05 months, 61% of the patients reported significant improvement in their symptoms, 22% had partial improvement, 13% were lost to follow-up and 4% did not respond to the treatment.

The study concludes that TCAs could be a good treatment option for patients who are not good candidates for surgery or those who refuse it. As far as the authors know, this is the first study to look at using TCAs to treat tenesmus in patients with rectal prolapse.

FAQs

  1. What is the main goal of the research paper on rectal prolapse surgery?
  2. What is tenesmus and how can it affect patients with rectal prolapse?
  3. What were the results of the study investigating the use of tricyclic antidepressants (TCAs) in treating tenesmus in patients with rectal prolapse?

Doctor’s Tip

If you are considering rectal prolapse surgery, it is important to discuss all treatment options with your doctor. They may recommend trying low doses of tricyclic antidepressants to help improve symptoms of tenesmus before opting for surgery. It is also important to follow up with your doctor regularly to monitor your progress and adjust treatment as needed.

Suitable For

Patients who are typically recommended rectal prolapse surgery are those who have tried other non-surgical treatments without success, have severe symptoms that significantly impact their quality of life, or have complications such as chronic constipation or fecal incontinence. Additionally, patients who are in good overall health and able to undergo surgery are also candidates for rectal prolapse surgery.

In the case of the study mentioned above, patients who were not suitable for surgery or refused it were treated with TCAs as an alternative treatment option. This suggests that patients who are not good candidates for surgery or who prefer non-surgical options may benefit from TCA treatment for tenesmus associated with rectal prolapse. However, it is important for patients to discuss their individual circumstances with their healthcare provider to determine the most appropriate treatment plan for their specific situation.

Timeline

Before rectal prolapse surgery, a patient may experience symptoms such as tenesmus, the feeling of needing to pass stools constantly, and the protrusion of the rectum through the anus. They may also experience constipation, fecal incontinence, and pelvic pain.

After rectal prolapse surgery, the patient may experience pain and discomfort in the anal region, as well as temporary difficulty with bowel movements. They may also need to follow a special diet and take stool softeners to prevent straining during bowel movements. Over time, as the surgical site heals, the patient should experience relief from their rectal prolapse symptoms and improved quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about rectal prolapse surgery include:

  1. What are the potential risks and complications associated with rectal prolapse surgery?
  2. What is the success rate of rectal prolapse surgery in terms of symptom improvement and recurrence?
  3. What is the recovery process like after rectal prolapse surgery?
  4. Are there any alternative treatment options to surgery for rectal prolapse, such as medication or physical therapy?
  5. How long will I need to stay in the hospital after rectal prolapse surgery?
  6. What is the long-term outlook for patients who undergo rectal prolapse surgery?
  7. Are there any lifestyle changes or modifications I should make before or after rectal prolapse surgery?
  8. How experienced is the surgical team in performing rectal prolapse surgery?
  9. What can I expect in terms of pain management and post-operative care after rectal prolapse surgery?
  10. Are there any specific pre-operative tests or evaluations I need to undergo before rectal prolapse surgery?

Reference

Authors: Livovsky DM, Adler SN, Adar T, Bar-Gil Shitrit A, Lysy J. Journal: Colorectal Dis. 2015 Dec;17(12):1094-9. doi: 10.1111/codi.13040. PMID: 26104058