Internal Rectal Prolapse in Children: A Hidden Cause of Constipation Requiring Comprehensive Evaluation and Treatment

Abstract

Internal rectal prolapse in children is a significant cause of persistent constipation that is resistant to medication. This condition, characterized by mucosal folds in the distal rectum, leads to obstructive constipation, rectal dilation, and potential fecal incontinence if not promptly diagnosed and treated. Symptoms include drug-resistant constipation, pain, facial flushing, sweating, crying, avoidance of the toilet, and straining during defecation. In advanced stages, loss of appetite and rectal bleeding may occur. Despite unsuccessful treatment with various laxatives, specialized pediatric gastroenterologists are unable to improve the condition. This study compared 153 pediatric patients with internal rectal prolapse to a control group of hospitalized children without the condition. Diagnosis and treatment approaches are discussed, emphasizing the importance of distinguishing this condition from other causes of constipation, such as Hirschsprung’s disease. Radiological findings and a classification system based on the thickness of prolapsed mucosa are also presented. Treatment options include sclerotherapy for lower-grade prolapse. However, the abstract should provide a more concise and accurate summary of the article.