Non-surgical treatment for rectal prolapse?

[AmateurHistorian]

I'm a 50 year old male. I recently discovered that I have a slight rectal prolapse, meaning that part of what's supposed to be inside me is starting to emerge outside. Obviously I can't see it, but I can feel it, and it feels like a pair of puckered lips emerging from my rectum. The prolapse isn't causing any problems so far, but I want to do anything I can to keep it from worsening, and reverse it if possible.

I've done lots of internet research on this. The prolapse is caused by weakening of the muscles and ligaments that hold the colon and rectum in place. Virtually every source I found says that the only treatment for prolapse is surgery. I found two doctors who claim that they can correct prolapse with physical therapy, but neither of them is anywhere near where I live, and I presume they wouldn't just tell me their techniques over the phone, for free.

The surgery-only answer -- even though it's the majority opinion -- doesn't wash with me. Surgeons have a vested interest in that answer, and physical therapists may not have ever tried to work with prolapse. I think there have to be some physical-therapy options. So I'm trying something on my own: Kegel exercises. These are best known as the exercises that pregnant women do to strengthen their vaginal muscles both before and after delivery. The same muscles also control defecation and urination by contracting the rectum and urethra.

Men have the same muscles, and they serve the same purposes -- except, of course, contracting the vagina. So my thinking is, if I do these Kegel exercises, which are simply sets of contracting and releasing the rectal-urethral muscles, that that will strengthen my rectum and prevent the prolapse from worsening, and possibly even reverse it.

(By the way, these same muscles control sexual ******, for both men and women, so Kegel exercises are also recommended for strengthening ******, and for women to tighten their vaginas. I believe this is also the basis of the methods described in the Kama Sutra and modern books for enabling extended intercourse and multiple male ******. Something fun to know and tell. )

So my question is, has anyone else tried this, or other physical-therapy techniques, for stopping and reversing rectal prolapse? I only started the Kegels two weeks ago -- I do them on alternate days, and I'm slowly building up the number of reps and sets -- and so far I can't tell any difference. I'm willing to consult doctors, physical therapists, sports trainers, anatomy books, medical journals, etc. -- but I thought I'd ask here first.

Anyone?

[AmateurHistorian]

I mentioned this post in another thread (http://forums.wrongdiagnosis.com/showthread.php?p=38748), and got this reply, which I thought I should copy here:

You may or may not wish to believe this, but acupuncture and Chinese herbal medicine is very helpful for most organ prolapse (anal, rectal, vaginal, uterine). There is a centuries old herbal formula called Bu Zhong Yi Qi Tang that is an empirical formula specifically for this problem.

Best wishes
DOM

I've had a lot of successful treatment in the past from practitioners of oriental medicine, and I trust it, so this could be my answer. However, I'm still doing my Kegel exercises, and I'll report back on what results I get from that.

[TheBlueBowl]

I joined this site just so I could reply to your post, AmateurHistorian. I too have a rectal prolapse. I thought it was hemorrhoids, and tried many things, but nothing that used to work for roid flare-ups was working anymore..and pain sitting (office job) was unbearable. When going to the bathroom, as another user said, it 'felt like my ******* was turning inside out'. This has happened in the past on occasion but was never a big deal. Lately, however, it won't go back in by itself, and is becoming harder and harder to push in. I, too, have spent much time on the internet (it is now 4 AM where I am, I've been awake since 12:30 AM worrying and thinking about this)..and I too saw that various types of surgery are presumably the only answer to this. Well, I'm with you--not an option I want to go for. It's interesting that you mentioned Kegels, because I had thought of that as well. So I started doing them today. Please do let me (us, the forum, whatever) know if the Kegels are helping you. I am female, aged 44. I'm really not sure why I"m having this "issue" (oh, good pun there) as I don't get constipated and didn't think I sat too long on the pot but who knows, maybe I do. Anyway, I'm scared stiff about '******* surgery' and will do anything to avoid it.
From my internet research I'm thinking of trying chinese herbs and/or acupuncture. I have never used either and dont know where to start. A colleague sees an acupuncturist for migraines and he says its been great, I suppose I could start there. ....
I'm glad to find an allie in this war against the prolapse. Of all things, this has got to be the most humiliating, among other things, ...but to keep it in perspective, I try to remember how much so many people go through all the time....(but i still don't want surgery!)

[AmateurHistorian]

Dear Blue,

True, rectal prolapse isn't anything I'd bring up at cocktail parties. But then, I never go to cocktail parties, so it's a not a big issue for me (yes, that is a good pun). But the most humiliating? For me, not even close ... which perhaps tells you something about my life. Anyway, I've raised two kids and worked in hospitals and hospices ... the rectum is just another part of the body.

As to the cause of prolapse, everything I've read says that it can be caused by chronic constipation and/or excessive straining of the bowel muscle, or by anal sex. But at least as often, its just a normal consequence of aging or inherently weak abdominal tissues. Put another way, prolapse happens.

Excessive straining could have been a factor in my prolapse. 15+ years ago I began to have some kind of chronic fatigue (recently diagnosed as caused by sleep apnea and a low degree of anxiety, both disrupting my sleep; I'm getting successful treatment for both). One of the features of my fatigue was that I always felt better after emptying my bowels -- not just the familiar, "Ah, that felt good," but actually stronger and more energetic. Sometimes emptying my bowels would save me two hours of sleep. None of the dozens of allopathic doctors to whom I've mentioned this had even the vaguest idea why that would be; one oriental medical practitioner gave me an explanation that made sense at the time, but I've forgotten what it was.

Anyway, many years ago I got into the habit of long, frequent sit-downs every day, because keeping my bowels as empty as possible helped me feel so much stronger. (Geeeez, isn't that only supposed to happen once you turn 75??) So it could be that my prolapse is a consequence of all that time on the toilet.

Yes, I'll definitely report back on what results I get from my Kegels. My life is very full through early June, including a long trip, so I probably won't write much until then. But then, physical therapy is a slow process, and I'm flying blind, so it'll probably take at least that long before I see any changes anyway.

Thankfully I'm not having any pain or discomfort from my prolapse (just the panic of first discovering it), either when I'm eliminating or just sitting in a chair. So I haven't needed to research anything for pain relief, and I don't know anything to suggest. If you're having that much pain, I definitely think you should call your doctor and/or do some more internet research. If the accupuncture, herbs, or other oriental treatments will help the prolapse, I assume they'd help the pain too.

But I also don't try to push my prolapsed rectum back in, and from what I know, I don't think that would be a good idea. Since prolapse is caused by weakened muscles and ligaments, I would think that pushing the prolapsed tissue back inside manually would have no effect, at best, or further weaken things and worsen the prolapse, at worst. (I haven't read anything that says this, or talked to a doctor, this is just my amateur understanding of anatomy.) On the other hand, I have thought about packing gauze tightly against my rectum at bedtime, hoping to ease the tension on the internal tissue for at least those hours of the day. Haven't tried it yet, though.

For sure, I won't consider surgery unless nothing else helps and things are getting worse. After 15-some years of mainstream doctors unable to help me with my chronic fatigue, and usually skeptical that it was even real, I've lost most of my trust in allopathic medicine. I'm continuing my Kegels, and will also talk to other people who might have suggestions about non-surgical treatments, including accupuncture and the Chinese herbal formula mentioned below. I know one alternative healer and one physical therapist whom I'll talk to soon, and I'll seek out others too. I'll report back whatever I learn.

If you do want to try some of the oriental techniques, yes, ask your colleague about his acupuncturist. Maybe your colleague knows more about oriental medicine and could give you other referrals too. And if you ask around, maybe other people you know also see oriental practitioners. If you live in a city of any size, there may be a school of oriental medicine that can give you referrals. I've seen quite a few oriental practitioners, and had many treatments including acupuncture, herbs, cupping, and energy balancing. A lot of them helped, none of them made anything worse, and most of the fees were quite reasonable (thank goodness, since none of this is covered by medical insurance, except sometimes acupuncture).

-- Chris

[acuann]

Well, in TCM(Traditional Chinese Medicine) school we learned about prolapses of uterus, rectum, anus as all conditions where the Qi is sinking. The classical Chinese patent formula for this condition is called Bu Zhong Yi Qi Tang.

Although I personally haven't treated this condition, I think acupuncture and Chinese medicine would be very effective, especially for milder or earlier cases. Here is a website that deals directly with this:

http://www.acupuncturetoday.com/arch.../01abbate.html

My personal feeling is I will try everything else before opting for surgery. If you can afford to give it some time, then please try acupuncture. You can always get the surgery eventually if you need it. And acupuncture will help speed the healing after surgery.

Best wishes
DOM

[AmateurHistorian]

ann, you're a blessing to everyone on this site. Thank you so much for all the information you've shared both here and in many many other threads that I've now read and contributed to. Obviously both I and Blue agree about surgery being an absolute last resort.

You say you have training in Chinese medicine; are you also an active practitioner?

[acuann]

Amateur Historian
Thank you for your kind words - you made my day.

Yes, I am currently a Doctor of Oriental Medicine and have a small clinic. It is very rewarding being able to help people in their journey towards health and well being.

Best wishes
DOM

[Unregistered]

I tried accupunture combined w/chinese herbs for my prolapse, but it didn't help any. Could be the practitioner was no good, though. So would not rule it out, just yet. I also have tried various herbs from the health food store as well as Galvanetic ionic therapy. Neither of those helped me any either...You want to know what I do? Fiber & stool softeners. Try to empty my bowels completely w/out straining. Most of all though, Everytime it starts to prolapse out, I go into the bathroom, spit on my finger & cram it back in as far as I can. Crude but effective, just wash your hands REALLY good afterward please! Sometimes it's 10 or 12 annoying times a day, sometimes only once, after a bowel movement...Which if you can, try & get in the habit of emptying them all at once & early in the morning. I usually shower after my main [& hopefully only movement] w/as hot a water as a can stand running on the anal area & then reverse it to ice cold...1st one & then the other for bit before getting out. Finally if you can lay on your side for a while & relax it will sometimes help make it stay in. I think a person could DEFINATELY improve some through physical therapy, but don't know if "kegals" are really the right one. Yoga is something I'm thinking about looking into, but haven't yet. I reallly doubt anything short of surgury will fully reverse a prolapse forever though, sorry to say...& of course even they have a failure rate & reoccurance factor, as well as the possibilty of making you even worse off.

[AmateurHistorian]

Man, this board is just making me laugh my prolapsed *** off tonight. You've got some really creative suggestions. I've never looked into any specific herbs for prolapse, or even heard of any other than the formula that acuann named. Never heard of Galvanetic ionic therapy either. I'll do some reading.

When you say fiber, do you mean packaged products like Metamucil? That stuff is way expensive, and I don't think I need it anyway; I eat a healthy vegetarian diet with lots of fresh vegetables and fruits. Empty bowels completely without straining, sure, that's ideal. Stool softener, hmm, not a bad idea. Although, like so much else, don't those cause problems if you use them steadily over a long period of time? Of course, I could add prunes back to my diet ... I love 'em, and have gotten out of the habit of eating them. (Geeez, I sound about 70 years old.)

"Spit on my finger & cram it back in as far as I can" is what really cracked me up. (Oh my, the puns just keep rolling.) Sure, I could do that, I'm not shy about using my fingers around my rectum. (I've had unpleasantly many occasions of constipation so severe and painful that the only way I could complete a bowel movement was to reach down and pull it out with my fingers. Reckon all the constipation mighta contributed to my prolapse? ~sigh~) And of course I wash very very thoroughly anytime I do, and disposable gloves are pretty cheap too. But the $64K question is, is the "cramming it back in" helping at all?

I already try to make my bowel movements as complete and as few as I can -- although as I said, keeping my bowels empty boosts my energy so much that I pretty much head for the head at the first feeling of fullness. I average 3-4 bowel movements a day.

Alternating hot and cold water on the rectum is also an interesting idea; I can see how that might help tone the rectal tissues. Again, do you find that it makes a difference for you? I'd love to lie down on my side more than I do (I sleep on my sides), but I don't get that opportunity much. After so many years of chronic fatigue and lying down far more than I wanted to, now that my health is returning, I stay as active as I can, including training for a physically demanding career that I hope to start soon.

Yoga is a good thought too. I've been doing a daily yoga routine for 8 or 9 months now and haven't noticed any effect from that on the prolapse. But then, it's a general routine that I learned from a "Yoga For Dummies" tape, and so maybe I should consult a real yoga teacher. ~grin~

Re. your lack of success with accupuncture & herbs, don't give up yet. It's been my experience that successful treatment from oriental medicine depends more on the individual practitioner than is the case with allopathic medicine. That doesn't mean that oriental medicine is any less valid. It just means that (a) for good or bad, allopathic pharmaceuticals usually do have some effect, and any idiot doctor can write scrips for them, and (b) oriental medicine requires a more intuitive and careful practitioner, and so the incidence of dud practitioners is perhaps higher in oriental medicine. So I would definitely try again with another practitioner. Look around for positive referrals from satisfied clients. If you should be so lucky as to get a referral from someone who was treated for rectal prolapse (and is willing to admit it!!), so much the better.

So my own plan is to, first, keep up the Kegels for awhile and see if I'm getting any results. If not, then I'll start talking to physical therapists, sports trainers, holistic M.D.'s, and yoga teachers, and see a DOM for acupuncture and/or herbs.

I'm also going to look into qi gong, which is another oriental healing art (based on a martial art, I think). It involves body poses and controlled breathing techniques, and I've been hearing from people who claim it's helped them control medical conditions for which allopathy has few or no answers. My original interest in qi gong was for treatment of my chronic fatigue and chronic depression, which I'm currently treating with allopathic methods and medications. Those have helped me dramatically so I'm not complaining about them as such. But I think I can improve even more, and I'm not at all keen on the idea of sleeping with a face mask connected to an air pump, and taking powerful pharmaceuticals, for the rest of my life. Anyway, it could be that qi gong can also address prolapses. I don't know, I've only done the most superficial reading on it so far.

Do please tell me whether the things I asked about above are helping you. I'm nowhere near ready to give up and go for surgery. I respect what surgery can accomplish, and I've met some top-flight surgeons who are also complete human beings. But as a group, I find surgeons to be arrogant ****** who don't adequately inform their patients about rates of failure, recurrence, and other negative consequences, and have trouble seeing the use of anything beyond their knives. Aside from trauma repair, I would never consider a surgeon a primary source of treatment advice.

[acuann]

Amateur,
I completely agree with you concerning Oriental Medicine and finding the right practitioner. As an acupuncturist, I am always seeking other practitioners to trade with and get treatments...some are colleaques, and, unfortunately, some just don't go the extra mile with their diagnosis. There are a zillion different methods of treating patients, but if they don't have a root understanding of basic Oriental Medicine diagnosis, then I believe there treatments won't be successful. So do shop around, for both allopathic and integrative treatments!


Qi Gong is fantastic, and is the precursor, or base upon which all Martial Arts are based. There are many different forms - google Qi Gong and illness and see what you find.

Best wishes
DOM