Our Summary

This research study looked at the physical changes in rectal tissue from people who have a condition called obstructed defecation syndrome, which makes it difficult for them to pass stool. This condition is often caused by the rectum (the last part of the large intestine) falling into itself, a situation known as internal rectal prolapse. To treat this, the researchers performed a surgical procedure to remove the affected part of the rectum.

The researchers compared the rectal tissue of 46 patients who had this surgery with the rectal tissue of 40 patients who had rectal surgery for cancer, to see if there were any noticeable differences. They found that the tissue from the obstructed defecation syndrome patients had more fibrosis (thickening and scarring of tissue) and nerve degeneration than the tissue from the cancer patients.

The findings suggest that these physical changes in the tissue may be a significant part of the problem in obstructed defecation syndrome. This is important because these changes are not currently considered when deciding on treatment for the condition. The study suggests that in the future, understanding these changes could help doctors better decide on the best treatment for people with this condition.

However, the study had a few limitations. For one, there were not many patients included, which means the results might not be the same in a larger group of people. Also, the study was retrospective, meaning it looked back at past data, which is not as reliable as collecting new data. In addition, the researchers couldn’t compare the tissue samples to those from healthy people, as they didn’t have any such samples.

FAQs

  1. What is the main finding of the research study on obstructed defecation syndrome?
  2. How might the findings of this study impact future treatment decisions for obstructed defecation syndrome?
  3. What were the limitations of this study on rectal tissue changes in obstructed defecation syndrome patients?

Doctor’s Tip

A helpful tip that a doctor might tell a patient about rectal prolapse surgery is to follow post-operative care instructions carefully to ensure proper healing and prevent complications. This may include taking prescribed medications, eating a high-fiber diet, avoiding strenuous activities, and attending follow-up appointments with your healthcare provider. Additionally, it’s important to communicate any concerns or changes in symptoms to your doctor to ensure the best possible outcome.

Suitable For

Overall, rectal prolapse surgery is typically recommended for patients with severe symptoms of rectal prolapse, such as chronic constipation, fecal incontinence, or the feeling of a bulge in the rectum. It is also recommended for patients who have tried conservative treatments, such as dietary changes or pelvic floor exercises, but have not seen improvement in their symptoms.

In some cases, rectal prolapse surgery may be recommended for patients with internal rectal prolapse, like those with obstructed defecation syndrome, who have significant physical changes in their rectal tissue that are causing their symptoms. However, the decision to undergo surgery should be made on a case-by-case basis in consultation with a healthcare provider, taking into account the individual’s overall health, symptoms, and treatment goals.

Timeline

Before rectal prolapse surgery, a patient may experience symptoms such as difficulty passing stool, a feeling of incomplete evacuation, rectal pain, and rectal bleeding. They may also undergo tests such as a colonoscopy or a defecating proctogram to diagnose the condition.

After the surgery, patients typically experience a recovery period where they may have some discomfort, swelling, and bleeding in the rectal area. They may need to follow a specific diet, take pain medications, and avoid strenuous activities for a period of time. Over time, they should see an improvement in their symptoms and a reduction in the risk of rectal prolapse recurrence.

Long-term follow-up may be necessary to monitor for any complications or recurrence of symptoms. Patients may also need to make lifestyle changes such as maintaining a healthy weight, avoiding constipation, and practicing pelvic floor exercises to prevent future issues with rectal prolapse.

What to Ask Your Doctor

Some questions a patient should ask their doctor about rectal prolapse surgery based on this research study could include:

  1. How will this surgery specifically address the physical changes in my rectal tissue, such as fibrosis and nerve degeneration?
  2. What are the potential risks and benefits of this surgery compared to other treatment options for obstructed defecation syndrome?
  3. How many patients have you treated with rectal prolapse surgery, and what has been their long-term outcome?
  4. Will I need any additional tests or procedures to evaluate the extent of my rectal prolapse before surgery?
  5. Are there any lifestyle changes or post-operative care instructions I should follow to improve the success of the surgery?
  6. Will there be a need for further follow-up appointments or monitoring after the surgery to ensure the rectal tissue heals properly?
  7. Could there be any potential complications or side effects related to the physical changes in my rectal tissue that were identified in this study?
  8. How will you ensure that the surgical procedure is tailored to my individual condition and needs based on the findings of this research study?
  9. Are there any ongoing clinical trials or research studies investigating new treatments for obstructed defecation syndrome that I should consider before proceeding with surgery?
  10. Can you provide me with more information or resources to better understand how rectal prolapse surgery may impact the physical changes in my rectal tissue identified in this study?

Reference

Authors: Brusciano L, Gambardella C, Falato A, Ronchi A, Tolone S, Lucido FS, Del Genio G, Gualtieri G, Terracciano G, Docimo L. Journal: Dis Colon Rectum. 2023 Aug 1;66(8):e826-e833. doi: 10.1097/DCR.0000000000002269. Epub 2022 Feb 28. PMID: 35239529