Rectum

Rectal Polyps generally do not cause abdominal pain. However, Rectal Polyps are precursors to the development of Rectal Cancer. Large Rectal Polyps can occasionally cause blood or mucus discharge from the anus.

Rectal Tumours (Cancer) do not usually cause abdominal pain unless they are in their more advanced stages. The symptoms of Rectal Cancer include fresh blood in stools and multiple episodes of diarrhoea. Tenesmus, which is described as a discomfort centred in the anus and lower pelvic region or a sensation of incomplete clearance of motion is also a common symptom. Loss of weight and abdominal pain are late symptoms.

Treatment of Rectal Cancer usually requires a combination of pre-operative radiation therapy with subsequent surgery to remove the cancerous segment of the rectum and restoration and continuity of the gut (so that the passage of motion remains via the anus) and possible postoperative chemotherapy. The surgery can often be performed as a keyhole/laparoscopic approach and this allows for faster recovery and less postoperative pain.

Ulcerative Colitis (UC) and Crohn’s Disease (CD) are collectively known as Inflammatory Bowel Disease. These are autoimmune conditions where the body attacks and damages itself. Ulcerative Colitis is limited to the colon and rectum whereas Crohn’s Disease can involve the entire gastrointestinal tract from the oesophagus to the anus.

Symptoms such as blood in the stools, unexplained weight loss, diarrhoea, discomfort of the anus and rectum and anaemia are common symptoms if the rectum is affected. In addition, Crohn’s Disease can give rise to anal fistulas which manifest as a recurrent perianal abscess or anal discharge at the region around the anus. Both conditions greatly increase the risk of Rectal Cancer.

Rectal Prolapse refers to the protrusion of the lining of the rectum beyond the anal opening. This means that the Rectal Prolapse can often be felt by the fingers when wiping or washing up. Rectal prolapse occurs more commonly among two age groups — young children and the elderly.

A Rectal Prolapse usually manifests as a lump in the anus. It is often accompanied by mucus and occasionally bloody discharge. The prolapse usually occurs when straining to pass motion. Depending on the severity of the prolapse, it can either return spontaneously into the rectum or require manual pressure to position it back. Patients with Rectal Prolapse often encounter a lot of difficulties with passing motion and can sit on the toilet bowl for a long time without passage of stools.

Rectal Prolapse surgery can be performed either from the anus/rectum or via a keyhole/laparoscopic approach through the abdomen. The decision will depend on the individual patient’s unique medical characteristics.

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