A rectal prolapse or anal prolapse is a really painful and embarrassing
problem to live with. But fortunately, there's quite a number of things you can do
at home to help fix your rectal prolapse and stop it worsening.
Hi, I’m Michelle, and today I’m going to guide you through how to fix your rectal prolapse at
home and how to stop it worsening. So I’ve got a couple of props here I’m going to use for this,
and this presentation is divided into two sections.
So this is going to be a rectal prolapse, and this is the anus. So we're going to go through how to
stop – the first part is to how to stop the rectal prolapse pushing down, so in other words, pushing
out like that. So this is the first part of our section that we're going to be going through,
and then the second part of the video is really important, it's going to be how to support from
underneath. So there's two things you really need to know, how to stop the prolapse pushing down
and how to then repair and improve support from underneath. So if you're living with a
rectal prolapse, you probably already know that this involves tissues, and tissues inside the
rectum that actually start moving down out of the anus, and that's the rectal mucosa or the lining.
Now, the [inaudible 00:01:14] the walls of the rectum can actually start to move down and out
of the anus as well. Usually, or hopefully, you can actually reduce it or push it back inside,
so it's coming out and down, you should be able to push it back inside. If you can't do that,
then that's a medical emergency and that needs surgical repair straight away. So
without further ado, let's go on to our strategies first of all that are going to help you to stop
the pressure pushing down, and there's six things you need to know to manage this well at home.
Now, here are the things you need to know to stop the rectal prolapse pushing down.
The first and golden rule, and probably one of the most important things I’m going to say to
you today is to never strain. Now, you can end up straining with constipation or with diarrhea,
so both of those things apply. Now, to not strain, we need to do a number of things, we
need to address our bowel, our stool consistency, and we need to address our technique. So I’m going
to go through the correct technique for emptying your bowel. I’m just going to go through this
fairly briefly, because I do have a video that details this, it's called MOO to POO and it's
listed above, and you can refer to that video for details. But basically, when you're emptying
with the rectal prolapse, you're inclined to want to pull your tummy in and push down and strain.
Now, when you do that, you close off the anal sphincter and make things worse. So to actually
open up, you actually need to bulge your tummy, so you're not going to pull in and push down,
you lean forward in this position, inward curve in your back, you take a number of deep breaths then
to relax and open the anal sphincter. And then what you do is you bulge your tummy forward and
you make your waist wide. So it's a mmm-ooh sound, and then you draw up and in through the anus at
the end. And it's really important that you try to get that rectal prolapse back inside after
you've finished your bowel movement, so you don't want it protruding, try and get it back inside.
Now, important things there, go with the first urge to empty, don't wait. Also too, you might
find it handy to use a Wet One, so Wet Ones wipe. So these are a really nice way of cleaning around
the rectum after you've emptied. So what you do is you use the wet wipe, make sure you get
or check the ingredients on the back, and make sure that the first ingredient is aqua or water,
and that they don't contain alcohol, because that can be really abrasive.
So with this type of a way of cleaning, it's much [inaudible 00:03:43] than using your toilet paper
which can be quite abrasive to the tissues there, and you might find that you've got to keep wiping
and you can't get clean. So using your last wipe as a wet wipe or using the wet wipes
is a really nice handy tip to keep yourself clean with this condition.
Now, the second thing I’m going to go through is correcting your stool consistency. So it's really
important to have the right stool consistency, which is a type 3 to 4 on this Bristol Stool Chart
here. So for the technique that I just showed you to work for the bowel emptying technique to work,
you need to have a soft well-formed stool. If the stool's too hard, then you're going to be inclined
to strain to empty; and if the stool is too soft again or with diarrhea again, you might need to
strain to empty, so we want to rectify that stool consistency. Now, once again, I do have a video up
above on foods to soften your stool. So the foods that soften your stool are foods like vegetables,
so we're talking about things like your spinach, your cruciferous vegetables like your greens,
red peppers, fruits like apricots, grapes, and also too your multi-grain. But if you're already
constipated, don't fill yourself with fiber, because that's going to give you a much larger
stool. What you need to do is, first of all, empty and then gradually increase your fiber.
So our fiber intake is really important. We should be having, adult males and females,
between 35 and 38 grams of fiber a day, and most of us only get to about 15 grams a day.
So a really nice way to rectify this is through a product called Psyllium or you can have Metamucil.
I actually tend to like the Psyllium husks themselves or it's also called Ispaghula husk.
But basically, you can use these husks, mix it with a teaspoon, start with a teaspoon, and mix
it with some yogurt or on your cereal or you can actually go to two teaspoons a day. Now, there's
a warning with that, it can make you gassy, and I personally find that I can't tolerate the
Psyllium, it gives me a lot of gas. So the other way you can actually overcome that and soften the
stool is through Osmolax or the osmotic laxatives, and these are things like your Movicol here,
you can also get Osmolax or MiraLax in the US as well. So those products are readily available.
When you take those, you need to, if you're having a teaspoon of Psyllium,
increase by a cup of water a day, because you also need the extra water to get everything through.
All right, now we've gone through those things so far, we've talked about bowel emptying, we've
talked about your stool consistency, let's talk about heavy lifting and exercise. So heavy lifting
will push that prolapse down, so I’ll just get my little prolapse again, so if you could imagine
the pressure from above, heavy lifting is going to push down and push that out. So things like
lifting a lounge, bending and squatting deeply are things not to do. You're much better off to lunge.
And does it [inaudible 00:06:50] doesn't mean that you need to stop your gym exercise.
It means that you need to exercise safely and that involves pelvic floor friendly exercises,
and you can refer to my book above, I’ve got those exercises detailed, gym exercises that
you can choose and gym exercises to avoid. You might also like to avoid high impact exercises,
so exercises like running and jumping where both feet are off the ground,
are going to create a large amount of impact, and they're going to push that prolapse down and out.
So remember, we're still talking about all these types of factors that will push everything out.
Another thing I’d like to mention is abdominal fat. So this here, I think this is a really
interesting visual, this is your fat. So this is five pounds or two and a half kilos of fat.
So you can imagine if you're carrying this on your abdomen, and what that actually does to
the prolapse. And so, if you're carrying a lot of abdominal fat in particular, it's going to push
that prolapse down. So something you can do that's really helpful with a rectal prolapse is to manage
your body fat, in particular your abdominal fat. So it's not going to be so much your arm weight
or fat on your legs, it's much more the abdominal body fat. And once again, I’ve got a video on
how to reduce abdominal body fat as well, and you might like to refer to that for more information.
So we've gone through a number of things there, haven't we – things that will actually stop
putting the pressure down, a lot to do with bowel management, also to do with exercise,
and also to do with you managing your body fat. Now, let's go through the key things to
improve support from below, and there's three main things that I want to go through. Now,
the first thing is doing your Kegel exercises. So Kegel exercises are really important because
they strengthen from below. So I’ve got a pelvis here that I can show you,
and here is a female pelvis; and basically the muscles through and around the rectum are the
same for the male and the female, and you can see how they encircle the anus there;
and what they do is they hold everything up when you're standing upright.
So this is one of your key ways of helping to fix and improve support through that area.
Now, Kegel exercises for men and women are slightly different. Again, I’ll put links below
for you to refer to Kegel exercises for men and for women, and also to how many repetitions and
exercises to do. But let's just go through that briefly now so that you know what you're doing.
When you do your Kegel exercises, start by putting the prolapse back inside if you can,
if that means to lubricate a finger, gloved hand, try to exercise and try to keep the
prolapse in as much as you can, that's a really important point. Try to do your exercises with
the prolapse in rather than out, because you don't want those tissues stretching.
So when you start your Kegel exercises, you think about tightening, squeezing,
and lifting inside the anus, and you might like to try that now as if you're stopping passing gas,
and that's the action to stop through there. But we also need to strengthen the other muscles,
these levator muscles in this platform here too to hold everything up. If you're a woman,
that means lifting and squeezing through the vagina; if you're a man, that means try to shorten
or attract the penis; and then for both sexes it involves stopping the flow of urine. So all three
actions altogether lift and support that area, and that's really vital for your prolapse management.
Now, the final management strategy I want to go through is doing a Kegel exercise for
when you have increased pressure downwards. So there's a way of counteracting that pressure
and it's a technique called the knack. So what I want you to do now is do a little tiny cough,
and you probably feel a little bit of a downward movement. Now, if you lift and squeeze through
the anus before and during that cough, try again now, so lift and squeeze, and again,
cough, and what you'll feel is much less downward movement. So every time before anything forceful,
before a cough, a lift, a sneeze, and, I mean, a heavy lift, if you can pre-brace and hold that
area up, you'll find that your rectal prolapse will be supported, and you'll stop that worsening.
So we've gone through a lot of things there, haven't we? We've talked about how to stop
the forces downwards on the prolapse, we talked about the importance of bowel management and diet,
we also talked about the importance of general exercise; and then we went through and talked
about the importance of Kegel exercises, keeping the prolapse internal as much as possible,
and also to protecting and activating those muscles when you need to. So I really hope
this information helps you to manage your rectal prolapse better at home.
As always, I really welcome your comments below in the section below. And if this video helps you,
please give it a like below, because then YouTube will recommend it to other viewers.
Thanks so much for watching today, I’ll see you next time. Bye for now.