Small bowel prolapse (enterocele) : Causes-Symptoms-Diagnosis-Treatment
What is Small bowel prolapse (enterocele)?
An enterocele, or little gut prolapse, could be a kind of girdle organ prolapse. It happens once the tiny guy prolapses, or drops, inflicting a bulge within the duct. biological time girls and ladies WHO have born are a lot of probably to develop enteroceles. preventive devices and Kegels (pelvic floor exercises) will facilitate.
Small gut prolapse, conjointly known as enterocele (EN-tur-o-seel), happens once the tiny gut (small bowel) descends into the lower cavity and pushes at the highest a part of the duct, making a bulge. The word "prolapse" means to slide or fall out of place.
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Small bowel prolapse (enterocele) |
Childbirth, aging and alternative processes that place pressure on your girdle floor could weaken the muscles and ligaments that support girdle organs, creating little gut prolapse that is probably to occur.
To manage little gut prolapse, self-care measures and alternative medical procedure choices are usually effective. In severe cases, you would like surgery to repair the prolapse.
Approximately three-dimensional to six of girls within the u. s. expertise in some kind of girdle organ prolapse. It most typically affects biological time girls WHO ar white or Hispanic.
Medical terms
Small intestine prolapse, conjointly known as enterocele (EN-tur-o-seel), happens once the tiny bowel (small bowel) descends into the lower cavity and pushes at the highest part of the canal, making a bulge. The word "prolapse" suggests that to slide or fall out of place.
Childbirth, aging and different processes that place pressure on your girdle floor might weaken the muscles and ligaments that support girdle organs, creating little intestine prolapse additional possible to occur.
To manage little intestine prolapse, self-care measures and different nonsurgical choices square measure typically effective. In severe cases, you will want surgery to mend the prolapse.
treatment An enterocele may be treated with surgery or conservatively (i.e. without an operation) by stretching the vaginal muscles to keep them supported Both of these approaches can cause problems however Conservative treatment can lead to increased loosening of pelvic floor muscles and recurrence of prolapse symptoms down the road Surgery to repair an enterocele almost always temporarily weakens the pelvic floor muscles so that they are more likely to weaken and prolapse in the future
An enterocele is a hernia within the wall of the small intestine and into the back layer of abdominal muscles forming a sac or pocket in which part of the intestine bulges It occurs during pregnancy when there is pressure on the abdomen from an enlarging uterus
Symptoms Small bowel prolapse (enterocele)
Mild small bowel prolapse may produce no signs or symptoms. However, if you have significant prolapse, you might experience:
A pulling sensation in your pelvis that eases when you lie down
A feeling of pelvic fullness, pressure or pain
Low back pain that eases when you lie down
A soft bulge of tissue in your vagina
Vaginal discomfort and painful intercourse (dyspareunia)
Many women with small bowel prolapse also experience prolapse of other pelvic organs, such as the bladder, uterus or rectum.
When to see a doctor
See your doctor if you develop signs or symptoms of prolapse that bother you.
Causes Small bowel prolapse (enterocele)
An enterocele happens once muscles, connective tissues and ligaments within the girdle region (pelvic floor) stretch or tear. These muscles and tissues support the bowels, womb and channel.
The small viscus is a component of the gastrointestinal system. Typically, muscles and ligaments hold the tiny viscus within the lower abdomen (belly) and higher pelvis. Weak tissues enable the organ to slide lower into the girdle space between the channel and body part. The tiny viscus then presses against the higher wall of the channel.
Increased pressure on the girdle floor is the main reason for any style of girdle organ prolapse. Conditions and activities that may cause or contribute to little viscus prolapse or different varieties of prolapse include:
Pregnancy and childbirth
Chronic constipation or straining with bowel movements
Chronic cough or bronchitis
Repeated heavy lifting
Being overweight or obese
Pregnancy and childbirth
Pregnancy and vaginal birth are the foremost common causes of girdle organ prolapse. The muscles, ligaments and fascia that hold and support your channel stretch and weaken throughout physiological state, labor and delivery.
Not everybody United Nations agency has had a baby develop girdle organ prolapse. Some ladies have terribly sturdy supporting muscles, ligaments and fascia within the pelvis and ne'er have drag. It is also potential for a girl who's ne'er had a baby to develop girdle organ prolapse.
Risk factors Small bowel prolapse (enterocele)
Factors that increase your risk of developing small bowel prolapse include:
Pregnancy and childbirth. Vaginal delivery of 1 or a lot of youngsters contributes to the weakening of your girdle floor support structures, increasing your risk of prolapse. The more pregnancies you have, the larger your risk of developing any variety of girdle organ prolapse. ladies UN agency have solely cesarean deliveries square measure less possible to develop prolapse.
Age. Small gut prolapse and different styles of girdle organ prolapse occur a lot typically with increasing age. As you grow old, you tend to lose muscle mass and muscle strength — in your girdle muscles in addition to different muscles.
Pelvic surgery. Removal of your uterus (hysterectomy) or surgical procedures to treat incontinence may increase your risk of developing small bowel prolapse.
Increased abdominal pressure. Being overweight will increase pressure within your abdomen, that will increase your risk of developing tiny internal organ prolapse. alternative factors that increase pressure embrace in progress (chronic) cough and straining throughout internal organ movements.
Smoking. Smoking is associated with developing prolapse because smokers frequently cough, increasing abdominal pressure.
Race. For unknown reasons, Hispanic and white women are at higher risk of developing pelvic organ prolapse.
Connective tissue disorders. You may be genetically vulnerable to prolapse thanks to weaker connective tissues in your girdle space, creating you naturally additional at risk of little internal organ prolapse and different forms of girdle organ prolapse.
What does an enterocele feel like?
Posterior vaginal wall prolapse occurs when the uterus and bladder lift up into the vagina creating a bulge in the back of the vagina This condition is sometimes called an enterocele An enterocele can cause a dragging sensation and painful pressure on your legs or reduce your ability to control urine flow In many cases an enterocele does not cause signs or symptoms but you may experience pain or pressure if there is trauma to surrounding tissues Other times an enterocele may occur with other pelvic floor disorders such as levator avulsion or cystocele (bladder prolapse).
Can the enterocele cause bowel obstruction?
An enterocele is a hernia of the small bowel that occurs after childbirth and can cause bowel obstruction The most common symptom of an enterocele is abdominal pain but only about 10 percent of people who have one actually seek medical care for this problem Other symptoms include constipation nausea bloating or difficulty with bowel movements.
Can a prolapse be fixed without surgery?
It is possible to treat a uterine prolapse without surgery While some women may choose to have surgery for a prolapsed uterus there are alternative treatment options available One such option is the use of a pessary which is placed inside the vagina and helps support pelvic organs in place A pessary can be used to help relieve symptoms of a prolapsed uterus or can be used in conjunction with vaginal or abdominal exercises that strengthen pelvic muscles Patients who opt for non-surgical treatments should talk with their doctor about having regular pessary check-ups to make sure the device is still in place and is not causing.
How painful is prolapse surgery?
Prolapse surgery is a major operation that has to be performed in a hospital under general anesthesia You will remain in the hospital for about 4-6 days after your surgery You will likely have pain from the incision site but it should subside within approximately six weeks This time will also allow time for you to regain some of your strength and mobility which are important factors as you recover from a prolapsed bladder or uterus or other pelvic floor disorder.
How long does it take to heal prolapse?
Prolapse is the slipping or falling of internal organs such as those in your abdomen and pelvis Prolapse can occur in both men and women but it happens much more frequently in women because females have a softer pelvic floor than males do This type of problem generally occurs when muscles that support the pelvic area are weak and cannot adequately hold up the organs As a result they begin to slip out of place.
What is the best exercise for a prolapse?
Exercising with a prolapse is important but it is more important that you choose the right exercise Talk to your doctor about the best exercises for your specific situation and condition Some common exercises to help avoid or relieve pelvic organ prolapse include: kegels regular squats planks and lying with your legs up on a chair while you relax in bed.
What happens if you leave a prolapse untreated?
If you have prolapse try to avoid lifting heavy objects and straining Women who have had multiple vaginal deliveries are more likely to develop uterine prolapse Weight gain can also contribute to the development of uterine prolapse To help prevent or treat these problems women should exercise regularly maintain a healthy weight throughout their life and avoid constipation.
Prevention Small bowel prolapse (enterocele)
You may be able to lower your chances of small bowel prolapse with these strategies:
Maintain a healthy weight. If you're overweight, losing some weight can decrease the pressure inside your abdomen.
Prevent constipation. Eat high-fiber foods, drink plenty of fluids and exercise regularly to help prevent having to strain during bowel movements.
Treat a chronic cough. Constant coughing increases abdominal pressure. See your doctor to ask about treatment if you have an ongoing (chronic) cough.
Quit smoking. Smoking contributes to chronic coughing.
Avoid heavy lifting. Lifting heavy objects increases abdominal pressure.
Diagnosis Small bowel prolapse (enterocele)
You may verify you have got Associate in Nursing enterocele once your tending supplier performs a girdle test. Your supplier will feel the bulge caused by the bowel pressing into your epithelial duct. Your supplier might raise you to cough or depress throughout the test in order that they will feel the bulge. They'll jointly perform a body part examination.
To confirm an identification of little internal organ prolapse, your doctor performs a girdle test. Throughout the test, your doctor might raise you to require a deep breath and hold it whereas bearing down like you are having a defecation (Valsalva maneuver), that is probably going to cause the prolapsed little internal organ to bulge downward. If your doctor cannot verify that you simply have a prolapse whereas you are lying on the test table, he or she might repeat the test whereas you are standing.
Imaging tests
include:
Treatment Small bowel prolapse (enterocele)
Small viscus prolapse usually does not like treatment if the symptoms do not bother you. Surgery is also effective if you've got advanced prolapse with teasing symptoms. nonsurgical approaches square measure accessible if you would like to avoid surgery, if surgery would be too risky or if you wish to become pregnant within the future.
Treatment choices for little viscus prolapse include:
Observation. If your prolapse causes few or no obvious symptoms, you do not want treatment. easy self-care measures, like playacting exercises known as physical exercise to strengthen your girdle muscles, might offer symptom relief. Avoiding work and constipation might cut back the chance of worsening your prolapse.
Pessary. A silicone, plastic or rubber device inserted into your canal supports the bulging tissue. Pessaries are available in a range of designs and sizes. Finding the correct one involves some trial and error. Your doctor measures and fits you for the device, and you find out how to insert, take away and clean it.
- Surgery. A medico will perform surgery to repair the prolapse through the duct or abdomen, with or while not robotic help. Throughout the procedure, your medico moves the prolapsed little intestine into place and tightens the animal tissue of your girdle floor. Sometimes, little parts of artificial mesh could also be wont to facilitate weakened tissues.A small intestine prolapse sometimes does not recur. However, additional injury to the girdle floor will happen with enhanced girdle pressure, as an example with constipation, coughing, fatness or work.
Lifestyle and home remedies
Depending on the severity of your condition, these self-care measures may provide the symptom relief you need:
Perform Kegel exercises to strengthen pelvic muscles and support weakened vaginal tissues.
Avoid constipation by drinking plenty of fluids and eating high-fiber foods, such as whole grains, and fresh fruits and vegetables.
Avoid heavy lifting.
Try to control coughing.
Lose weight if you're overweight or obese.
Avoid bearing down to move your bowels. Rely on your natural colorectal function to empty your lower bowel.
Quit smoking.
Kegel exercises
Kegel exercises strengthen your girdle floor muscles, which, in part, support the female internal reproductive organ, bladder and viscus. A robust girdle floor provides higher support for your girdle organs, prevents prolapse from worsening and relieves symptoms related to girdle organ prolapse.
To perform physical exercise, follow these steps:
Tighten (contract) your pelvic floor muscles — the muscles you use to stop urinating.
Hold the contraction for five seconds, then relax for five seconds. (If this is too difficult, start by holding for two seconds and relaxing for three seconds.)
Work up to holding the contraction for 10 seconds at a time.
Aim for at least three sets of 10 repetitions each day.
Ask your doctor for feedback on whether or not you are victimizing the correct muscles. physical exertion is also most triple-crown once they are instructed by a therapist and bolstered with training programs. the training program involves victimization observance devices that facilitate guarantee you are adjusting the correct muscles, with best intensity and length of your time.
Once you've learned the proper method, you can do Kegel exercises discreetly just about anytime, whether you're sitting at your desk or relaxing on the couch.
Preparing for your appointment
Your 1st appointment is also along with your medical aid doctor or with a doctor UN agency focuses on conditions touching the feminine generative tract (gynecologist) or the generative tract and urogenital system (urogynecologist, urologist).
What you can do
Here's some information to help you prepare for your appointment.
Make a list of any symptoms you've had and for how long.
List your key medical information, including other conditions for which you're being treated and any medications, vitamins or supplements you're taking.
Take a family member or friend along, if possible, to help you remember all the information you'll receive.
- Write down questions to ask your doctor, listing the foremost necessary ones initial just in case time runs short.For small gut prolapse, basic inquiries to raise your doctor include:
Is the prolapse causing my symptoms?
What treatment approach do you recommend?
What will happen if I choose not to have the prolapse treated?
What is the risk that this problem will recur at any time in the future?
Do I need to follow any restrictions to prevent progression?
Are there any self-care steps I can take?
Should I see a specialist?
Don't hesitate to ask other questions during your appointment as they occur to you.
What to expect from your doctor
Your doctor may ask questions such as:
What symptoms do you have?
When did you first notice these symptoms?
Have your symptoms gotten worse over time?
Do you have pelvic pain? If yes, how severe is the pain?
Does anything seem to trigger your symptoms, such as coughing or heavy lifting?
Do you have urine leakage (urinary incontinence)?
Have you had an ongoing (chronic) or severe cough?
Do you often lift heavy objects during work or daily activities?
Do you strain during bowel movements?
Do you have any other medical conditions?
What medications, vitamins or supplements do you take?
Have you been pregnant and had vaginal deliveries?
Do you wish to have children in the future?
General summary
- If you have an enterocele it is considered a serious condition A myomectomy may be needed to correct the problem of an enterocele as well as other pelvic floor surgeries An enterocele may progress in size and cause further damage to the internal organs if left untreated You should consult with your doctor about whether or not surgery is necessary for you.