| Theme |
Current Topics on Anorectal Disorders |
| Title |
Mucosal Prolapse Syndrome : Diagnosis and Treatment |
| Author |
Takayuki Morita |
Institute of Surgery, Aomori Prefectual Central Hospital |
| Author |
Minoru Umehara |
Institute of Surgery, Aomori Prefectual Central Hospital |
| Author |
Shinsuke Nishikawa |
Institute of Surgery, Aomori Prefectual Central Hospital |
| Author |
Yasunori Mikami |
Institute of Surgery, Aomori Prefectual Central Hospital |
| Author |
Harue Obara |
Department of Surgery, Hirosaki University School of Medicine |
| Author |
Motoi Koyama |
Department of Surgery, Hirosaki University School of Medicine |
| [ Summary ] |
Mucosal prolapse syndrome is a complex evacuation disorder characterized by a benign ulcerative lesions of the middle rectum and polypoid lesions of the lower rectum. The main symptom is rectal bleeding, but mucus discharge and difficult evacuation may also be associated. Patients complaining of obstructed evacuation and rectal bleeding are examined with endoscopy, barium enemas and defecography. Inflammatory changes may consist of replacement of the normal lamina propria by fibroblasts arranged at right angles to the muscularis mucosae (fibromuscular obliteration). The microscopic appearance, however, is quite variable and can include loss of normal polarity of the glandular epithelial cells, shortening of the crypts, mucin depletion, hyperplastic mucosal thickening, and mucus lakes. Although surgical treatments such as transanal or transsacral simple excision may offer some degree of palliation of symptoms, the primary treatment for patients with this disease is aimed at education concerning bowel habits to avoid straining. A high-fiber diet with bulk laxatives is recommended. |