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Although both men and women are affected by permanently enlarged haemorrhoidal cushions, mostly women _ suffer from constipation or frequent bowel movements. Besides nutrition-related, mental or genetic (excessively long colon) causes, we are encountering an increased number, where an overextended rectum is the cause for chronic constipation in more and more cases. Weakness of the tissue is once again the main cause in this case. The wall of the rectum is overextended, especially on the front side towards the vagina.
An overextended and/or extended intestine should always be viewed in context with the pelvic floor which keeps the intestine, above all the colon and the rectum, in position. Weakening and/or deformation of the pelvic floor muscles are often the cause of the problems discussed here.
Due to hard pressing during defecation stool collects in an intestinal pouch (rectocele - red spot in the picture) resulting in prolonged discharge accompanied by uncomfortable and extreme pressing. Some of our female patients describe a sensation of incomplete discharge – which in many cases is accurate, as stool remnants often collect in the rectocele. These problems illustrate one extreme of the possible functional problems. The same organic cause however may also lead to a very frequent urge to defecate, more or less successfully. In case of an elongated colon, the inherent movement of the intestine may not be sufficient to discharge the stool in on time. The consequence is constipation once again.
Constipation and laxatives
Due to permanent strong pressing during bowel movement, the intestinal wall is overextended even more, which may lead to an enlarged rectocele. Upon reaching a certain size, the rectocele can press against the vaginal wall .. causing the sensation of a small bump or foreign object in the vagina. This can become so grave, the affected persons can only produce a bowel movement using laxatives or through manual assistance using their fingers. The permanent use of laxatives has a damaging effect on health because it deprives the body of important fluids_. Additionally, laxatives promote colonic inertia because they liquify the stool. As a consequence, the stool is discharged without sufficient inherent movement of the intestine. If - laxatives are only used occasionally, this does not lead to severe consequences. However, a vicious cycle develops with the permanent use of laxatives which is hard to break. In some cases the colon stops its natural motions altogether.
Rectal prolapse is another frequently arising problem with similar complaints. This is caused by the slackening of the entire rectum wall. The stretched excess tissue (prolapse) protrudes into the rectum and/or anal canal and blocks the transport path. This aggravates or even prevents normal bowel movement. If this development is allowed to continue, the prolapse gets larger and the described problems increase. In the end, the rectum may even slip out during bowel movement.
Constipation but faecal incontinence at the same time?
If the anal sphincter is strained through permanently inverted tissue and strong pressing, it may become overextended. The continence mechanism no longer works properly, which leads to faecal incontinence. The first symptoms may be involuntary flatulence and/or soiling of the underwear.