Rectal Prolapse
Mechanically, it is an intussusception of the rectum - Sean M. Fox
image by: RECTUM
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Sugar the Rim
How to reduce a rectal prolapse
- Step One: Apply gentle steady pressure with a gloved hand
- Step Two: If you have difficulty reducing the prolapse, apply granulated sugar to the prolapse.
- Step Three: Let the sugar sit for 15 minutes and then reattempt the reduction. The sugar will absorb the extra water and cause the prolapse to shrink.
- Step Four: If “sugaring the rim” fails, the next step is surgical reduction – so call your consult and pass that baton!
- Pro Tip: Yes, you must use granulated sugar. A sugar substitute will not work! (Sorry, no Splenda!)
Resources
Brown EM Whit-icisms: Rectal Prolapse
You are called to the bedside by nursing for an elderly patient with the chief complaint of “my insides fell out.” On closer examination, you discover that the patient has suffered from a rectal prolapse. You attempt manual reduction, but have little success. Now what?
Podcast 792: Rectal Prolapse
Rectal prolapse is an evagination of the rectal tissue through the anal opening. Factors that weaken the pelvic floor muscles increase the risk of rectal prolapse.
Rectal Prolapse & Pediatrics
Mechanically, it is an intussusception of the rectum. Unexplained rectal prolapse deserves follow-up for possible cystic fibrosis testing.
Trick of the Trade: "Pour some sugar on me" | Reducing a rectal prolapse
Rectal prolapses often are associated with quite a bit of rectal mucosal edema. Sprinkle granulated sugar onto the area. Wait 15 minutes. The sugar reduces the edema by osmotically drawing out the fluid. The prolapse often reduces spontaneously or with gentle manual pressure.
Sugar the Rim
It was my first month of intern year, and I had just presented a patient with a recurrent rectal prolapse. Ben Schnapp, the senior resident, was delighted to show me what he said was the “the funniest therapy that actually works.” I followed Ben up to the cafeteria, where he rummage through the concessions grabbing several stray sugar packets. This was to become a teaching pearl that, despite my best efforts, I would never forget.
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