Knowledge about the structure, functionality of the rectum gives a person more opportunities to understand how diseases of this organ are formed, and to learn ways to cure these ailments.
What is the rectum
The rectum is part of the gastrointestinal tract. The gastrointestinal tract combines the oral cavity, pharynx, esophagus, stomach, the size of the thin one is about five meters. It flows into the large intestine, the last section of which is the rectum. Its size is no more than one and a half meters.
The rectum, like the last part of the intestine, is located in the lower part of the pelvis.
It got its name due to the fact that it has slight bends.
The rectum is an indicator of the efficiency of the gastrointestinal tract. Its dimensions and length change throughout a person's life.
In the process of removing processed products from the human body, the rectum has one of the main roles. It also performs an important function during the absorption of liquid.
The state of the internal organs and systems of the human body depends on how the rectum works.
What is the length of a person's rectum
This question can only be answered approximately. How long a person's rectum is is determined by age. Almost all organs grow as they grow older. Based on this, one can only approximately answer the question - how long is the rectum. Scientists indicate only average values. The length of the rectum of an adult is from thirteen to twenty-three centimeters. This is one-eighth the size of the lower intestine.
The length of the rectum of a newborn is small in relation to the size of other parts of the gastrointestinal tract. Doctors, just like adults, know only approximate sizes. Fifty millimeters is the average length of the rectum. Representatives of both sexes of humanity do not have significant differences in size.
Rectum sections
Upon a detailed examination of the structure of the human rectum, three formations are conditionally distinguished:
- Crotch. It has four borders. Also, this section of the rectum is divided into two triangles. The first of these is the genitourinary. In men, it contains a canal for urination. In women, the vagina joins the canal, respectively. In the anus triangle, regardless of gender, is the anus.
- Anus. This is the final part of the gastrointestinal tract and rectum, respectively. The opening of the passage is visually similar to the gap leading into the canal. The view of the rear opening is different for males and females. The male anus is like a funnel. And the female one is either completely flat and flat, or protrudes forward.
- Skin around the anus. It differs in color from the rest of the epidermis. Also around the anus, the skin is severely wrinkled. This is due to the external sphincter. The anus has a diameter of three to six centimeters, a length of up to five. The anal opening and rectum have blood vessels and nerve endings that allow you to regulate bowel movements (the process of excreting feces) of the body.
Sphincters
In the rectum, two sphincters are distinguished - involuntary and voluntary. The first is inside the body. It serves as a separator between the intermediate bend and the end of the rectum. The involuntary sphincter consists of muscles placed in a circle. Sizes range from one and a half to three and a half centimeters. In men, the involuntary sphincter is thicker than in the fair half of humanity.
The voluntary sphincter is located outside. It is under human control. The sphincter is a striated muscle extending from the muscles of the perineum. Size - from twenty five millimeters to fifty.
Features and length of the rectum in women
Comparing the anatomy of both sexes, there are no colossal differences. The length of the rectum in men and women is the same. The weak half of humanity, however, has a number of anatomical differences.
In the female body, the rectum is located in close proximity to the vagina, namely, it is located in front of it. Of course, there is a layer between them. However, it is so thin that it is not able to resist the migration of purulent and tumor processes from one organ to another.
In view of these female anatomical features, the fairer sex often suffer from rectovaginal fistulas. They are the result of trauma or severe tears in the perineum during childbirth.
Functions
The main function of the rectum is to eliminate waste products from the body. The process of defecation is regulated by human consciousness.
The next most important function, after the excretion of feces, is the absorption of fluid. About four liters of water per day is returned to the human body during processing, pressing and dehydration of feces. In addition to water, the rectal mucosa absorbs minerals and trace elements and thus reverses them back.
Also, the human rectum has a reservoir function. This is explained by the following: feces are collected in the ampulla of the intestine. As a result, pressure is exerted on its walls. They stretch, a nerve impulse is given, indicating the need to start defecation.
Due to its importance, the rectum must function normally. She is very sensitive to various kinds of painful sensations and conditions. For example, constipation provokes stool stagnation. And this, in turn, leads to intoxication of the human body. It is also possible to relax the intestines at the end of the fermentation of processed foods.
Rectum work
As already mentioned, the main task of the rectum is to remove feces, toxins and other harmful substances from the human body. The functionality of the entire digestive system depends on its correct operation. In the rectum, all unnecessary substances accumulate and then are excreted.
In the event of a malfunction, all this waste will rot, collecting together and thereby poisoning the body. That is why it is extremely important to monitor the health of the rectum.
Conventionally, the work of the rectum is divided into static and dynamic. The first is the accumulation and retention of feces and harmful substances. When excrement collects in the intestine, it becomes wider, the folds of the mucous membrane stretch. Harmful substances, due to the anal press and tightly compressed walls, fill the entire length of the rectum. The photo above contains information on the direction of their withdrawal. And the sphincter prevents the spontaneous release of gases and waste products from the intestines.
Dynamic work consists in removing accumulated harmful substances from the human body. The process of bowel movement is called defecation. The moment when it should happen is realized through the nerve endings. It happens that a person has the urge to defecate, but the rectum is actually empty. Such situations occur when a person's gastrointestinal tract is disrupted. In most cases, this indicates the occurrence or development of various diseases.
Human intestinal defects
Unfortunately, rectal defects develop before birth. The reasons can be various factors, and it makes no sense to list them. Basically, two parts of the intestine are affected - this is the perineum and the most common defects:
- Cloaca.
- Atresia (infection).
- Fistulas are chronic inflammatory processes.
Congenital malformations without the formation of fistulas become noticeable after the birth of the baby, during the first day. The cause of this ailment is the low permeability of the intestine. Symptoms include food neglect, nausea, vomiting, and overexcitement.
The doctor recognizes an overgrowth of the anus immediately after birth. However, for an accurate diagnosis, examinations will be needed. Often this defect is a consequence of the formation of fistulas in the perineum or in the genitourinary system. The main symptoms are the excretion of feces through the vagina. Already based on a certain size, the doctor prescribes treatment methods. Fistula is diagnosed using X-ray studies. This procedure is called "fistulography".
It is performed by a radiologist and a surgeon. An examination is carried out, reporting the presence of an allergic reaction to iodine. Before the procedure, its contents are withdrawn from the fistula using a syringe. The fistulous canal is flushed. A catheter is then inserted into the fistula opening through which a contrast agent (containing iodine) is injected. The volume of the radiopaque fluid directly depends on the size of the fistulous canal. It must be completely filled with contrast agent.
After insertion, the fistula opening is closed with a gauze ball and sealed with a plaster. X-rays are being taken. eliminated, or it flows out on its own. In some cases, it is permissible to carry out the procedure under anesthesia.
In cases of diagnosed fistulous atresia, the child is immediately referred for surgery. In some situations, surgery is delayed until the age of two. These include vaginal and vestibular fistulas. Until the required age is reached, the child eats in accordance with a special diet, which includes foods that have a laxative effect. And bowel emptying occurs through enemas.
Pathology in the form of narrowing of the rectum is diagnosed using proctography and rectoscopy. Most of the treatment consists of eating according to diet and bougienage. The latter is the introduction of a flexible or rigid rod into the affected organ in order to stretch the intestine. The inserted tool increases in diameter each time. And in this way, the opening of the rectum is gradually stretched. The number of procedures varies individually.
Only girls are susceptible to pathology in the form of a congenital cloaca. This defect looks as follows: the urethra, vagina and the entire length of the rectum are combined into a common canal. In women, this pathology can be eliminated only with the help of surgical intervention.
Based on long-term statistics, doctors are forced to agree with the fact that any damage to the intestine is life-threatening for the human body. Internal breaks are especially fraught. Only a timely visit to a specialist will save your life and will not cause any inconvenience in the future.
Symptoms of rectal diseases
Each disease has certain symptoms. But nevertheless, it is worth highlighting the frequently occurring signs.
If any of the listed symptoms appear, it is necessary to urgently consult a specialist:
- Painful sensations in the anal canal.
- Feeling of something foreign in the rectum.
- Discharge from the rectum.
- Bleeding.
- Constipation.
- Fecal and gas incontinence.
- Itching of the anus.
It is worth noting that some diseases of the rectum tend to develop at first without any symptoms.
Diseases and their treatment
Diseases of the rectum are undoubtedly a very intimate issue, which is appropriate to discuss only with a specialist or a loved one. As mentioned earlier, not paying attention and enduring threatens not only complication, but also death. And the treatment started on time gives an excellent opportunity for a complete recovery.
Common diseases of the rectum:
- Proctitis is an inflammation of the rectal mucosa. As soon as the disease originated in the human body, symptoms will appear immediately. Signs of proctitis include: diarrhea, pain, false urge to defecate, the presence of mucus and blood streaks in the stool. There are a great many reasons for the appearance of the disease. The treatment process is based on eliminating the symptoms of proctitis and the cause of its occurrence.
- Rectal prolapse. The condition is also known as hernia. It consists in the exit of the rectum beyond the boundaries of the anus. In addition, its fixation is violated. Frequent bowels are accompanied by bleeding. Treatment is exclusively through surgery.
- Anal fissure. Symptoms of the disease are cutting pain during bowel movements, scanty bleeding at the end of bowel movements. It is quite possible to diagnose an anal fissure when examining the rectal lumen. If the disease has progressed into a chronic stage, surgery will be required for treatment.
- Polyposes are non-malignant formations located in the lumen of the rectum. The disease does not cause inconvenience to the person, and he simply does not notice it. Polyposis reveals itself in case of injury or reaching large sizes. This is expressed through anal bleeding. Treatment for polyps is surgical removal.
- Coccygodynia is difficult to diagnose, because painful sensations in the rectum are not accompanied by visual evidence of its defeat. Disease activators are muscle injuries and spasms that cause the anus to move upward. During the time the patient feels psychologically uncomfortable, therefore, it provides for the presence of a psychotherapist, neurologist or neurosurgeon.
- Hemorrhoids - varicose veins of the rectum, namely in the anus. The two main symptoms of this rectal disease are bloody discharge and prolapse of nodes from the anus. Also, in addition to the listed signs of hemorrhoids, there is a feeling of heaviness and the presence of a foreign body in the rectum, itching, burning and pain in the anus, painful bowel movements. The dilated parts of the veins interfere with the normal excretion of feces, are injured, thrombosed.
The causes of the disease are varied: laxatives, frequent use of enemas, oral contraceptives, excessive hygiene of the anus, unbalanced diet, anal sex, regular cycling, horses, motorcycle, pregnancy. Often, this disease affects people whose professions involve sedentary work, for example, drivers, programmers.
Currently, there are many ways to treat hemorrhoids. In each individual case, the specialist selects the necessary technique that will treat the disease, as well as minimize painful sensations and inconveniences. However, it should be noted that quick and painless healing is possible only in the early stages. Hemorrhoids tend to develop very quickly, and, as a result, you have to lie on the operating table under the surgeon's knife. And then follow the strict rules of the postoperative period.
- Paraproctitis is a purulent inflammatory process formed on the tissue surrounding the anal canal. The characteristic features of the disease are sharp pulsating pain in the perineal region, induration in the anal part, local redness and fever. Treatment of this disease of the rectum is possible only with the help of a surgical operation. Moreover, a medical intervention carried out at the wrong time threatens with generalization of the disease and fever. Chronic paraproctitis is a rectal fistula, since the inflammatory process is accompanied by a fistula that breaks through the intestines or skin in the anal area. At this stage of the disease, healing is the treatment of a fistula in the acute stage and surgical elimination of it after the inflammatory processes become less active.
- Crayfish. The disease itself does not inspire hope, plus everything is extremely dangerous due to the asymptomatic course in the early stages. A person discovers the first symptoms at the moment when the disease has already affected a significant area. Cancer symptoms are pain and foreign body sensation in the anal canal. When these signs of the disease are detected, only radical treatment is already possible. Based on this, one should not dismiss minor inconveniences in the anus or rectum. Do not hesitate and see a doctor.
There are many more diseases of the rectum. They are much less common, but this does not mean that they are less dangerous.
Research in the field of proctology is aimed at identifying diseases that affect the rectum and the rest of the intestine. Patients with complaints of rectal discomfort, constipation, diarrhea, the presence of bloody discharge and mucus in the feces are examined. Patients with pathologies of the upper regions of the gastrointestinal tract, and cases with a predisposition are subjected to diagnosis.
There are many ways to diagnose diseases of the rectum, among which you can choose the most convenient and affordable.Modern medicine provides diagnostic rooms with innovative equipment for conducting examinations to identify pathologies of the rectum.
General rules for preparation
Examination of the rectum is carried out by several methods, differing in the method of execution, the equipment used with the diagnostic material. But they all imply the implementation of the general rules for preparing for the procedure. On the eve of the examination of the rectum, the patient must completely cleanse the intestines. Preparation is done in several reliable ways:
- Water enemas. To increase the effectiveness of preparatory measures, it is recommended to eat liquid meals a day before the study, to give up high-calorie and nutritious cereals, muffins, as well as vegetables with fruits, foods that cause gas in the intestines. For 8-10 hours 2-3 enemas are done with 1.5-2 liters of warm water. The breaks between the stages of bowel processing are 30-60 minutes. An additional 2-3 enemas are given a couple of hours before the examination.
- Microclysters, such as "Norgalax", "Normacol", "Adyulax", are injected into the rectum in order to irritate the receptors that cause the urge to defecate. Enough twice at intervals of 15 minutes. The method does not require a diet, it is fast and comfortable. But allergies are possible as a response to inflammation in the rectum, therefore microclysters are not recommended for internal ulcers, Crohn's disease.
- Medicines with polyethylene glycol, for example, "Fortrans", "Fleet-phosphosod", "Endofalk". The selected substance is dissolved in 1-4 liters of water, according to the instructions. Part of the drug is drunk a couple of hours before the examination. A complete bowel cleansing is carried out in 12 hours. Suitable for fibrocolonoscopy, irrigoscopy.
Rectal-digital examination
Used first when making a diagnosis. The procedure is carried out when the patient complains of pain, intestinal dysfunction. Rectal digital examination of the rectum is used:
- to determine the condition of the tissues of the anal muscle;
- assessing the severity of damage to all parts of the rectum;
- classification of the pathological process.
The rectum is examined when the patient is located in different positions: lying on his back or on his side, in the knee-elbow position. The method is contraindicated for sphincter spasms, severe narrowing of the anal canal, cutting pains in the anus.
Before rectal palpation, the doctor examines in detail the condition of the anal area. An external check of the condition allows you to identify fistulas, external hemorrhoids and thrombosis, to determine the degree of damage to the skin around the anus and the force of closing its edges. But a more accurate assessment of the condition is given by fistulography or profilometry.
Palpation is carried out with the index finger in a medical glove. To reduce the feeling of discomfort, the finger is lubricated with petroleum jelly, the anus is treated with an anesthetic gel. The examination is carried out in two stages: with tense and relaxed sphincter muscles. No special preparatory steps are needed. Natural bowel movements are sufficient.
Anoscopy
The examination is carried out by a proctologist using an anoscope. The device is inserted into the anus for additional examination of the extent of the damage caused by the disease. The technique is used if there is:
- pain in the anal canal;
- traces of blood, mucus, pus;
- alternating constipation with diarrhea;
- suspected inflammation.
During anoscopy, the doctor examines the anus, anal canal, rectum with hemorrhoid nodes located inside. The bowel section with a depth of 80-100 mm is subject to inspection. Profilometry is carried out in a similar way.
The procedure is performed after palpation of the rectum, but before the use of sigmoidoscopy and colonoscopy. The technique is based on the gradual introduction of the anoscope in circular movements in a supine position. After reaching the required depth of the valve flap, the intestinal lumen is expanded before examination.
This type of endoscopy is painless, safe and effective, unlike gastroscopy. You can not use anoscopy for acute inflammation of the anus, severe narrowing of the lumen of the anal canal, fresh burns and stenosing tumors.
Sigmoidoscopy
This common method allows for an informative rectal examination to obtain reliable data on the condition of the intestine. For carrying out, a sigmoidoscope is used, which is inserted to a depth of 35 cm from the anus. The method is a separate type of endoscopy.
In addition to pain in the anus, discharge of pus, mucus with blood, irregular bowel movements, the procedure is used to establish the nature of the pathology of the sigmoid colon. Effectively used to detect early stages of rectal cancer.
The essence of the technique: the introduction of the device at a given depth in the knee-elbow position. To increase the lumen of the intestine, air is introduced while pushing the sigmoidoscope. If sudden pain occurs, you should inform your doctor about it so that he can make sure that there is no damage. On the eve of the survey, you need to carefully prepare.
Irrigoscopy
The method refers to X-ray types of studies using barium sulfate contrast, which is injected into the rectum. During the examination, you can:
- determine the size, location, shape of the intestinal lumen;
- to inspect the walls of the organ to determine the extensibility with the elasticity of their tissues;
- determine the state of all parts of the intestine.
Irrigoscopy examines the functionality of the intestinal flap between the ileum and the colon. With stable work, the intestinal contents go from the thin to the thick sections. With dysfunction, the process is reversed, as can be seen by the movement of the contrast. The relief of the mucous epithelium is also assessed, the condition of which makes it possible to check the presence or absence of ulcers, diverticulosis, fistulas, cancer or other formations, congenital developmental pathologies, scarred narrowings. The method is most effective when combined with fistulography.
Irrigoscopy is safe, painless, non-traumatic. The double contrasting method is endowed with the maximum information content, which detects polyps and other tumor formations. Contraindications to the method are wall perforation and serious condition of the patient.
Aimed at the timely diagnosis and prevention of diseases of this part of the intestine. This largely determines what kind of treatment will be prescribed in the future. Let us consider in more detail the types of such studies and the features of their implementation.
Diseases of the rectum are distinguished by the variety of their symptoms. Usually (in the initial stages), pathology almost does not manifest itself in any way, therefore it is rather difficult to detect it on its own.
In a more advanced state, the disease is characterized by frequently recurring symptoms, which may include:
- Decreased appetite.
- ... In this case, the nature of the pain can be different (stitching, burning, aching, bursting, etc.).
- Constipation.
- Violation of the usual frequency of bowel movements.
- Prolapse of hemorrhoids.
- Acute pain during bowel movements.
- Itching in the anus.
- Feeling of heaviness in the abdomen.
- The appearance of frequent bleeding in the stool.
- Bloating.
- Flatulence.
- Diarrhea.
- Rapid weight loss.
If at least two of the above symptoms occur, you should contact a proctologist as soon as possible.
The following groups of people are most susceptible to rectal diseases:
- People leading a sedentary (sedentary) lifestyle.
- Aged people.
- Smokers and those who frequently drink alcoholic beverages.
- People who don't eat well.
Rules for preparing for examination by a proctologist
Immediately before visiting a proctologist, a person should prepare for an examination. To do this, it is advisable to do the following procedures:
- Carry out cleansing enemas.
- The day before the examination, you need to reduce the use of cereals, flour products and products that can cause flatulence.
Also, preparation provides for microclysters so that the rectum is completely cleansed and the doctor can better examine its walls and mucous membranes.
Important! Diagnostics of the rectum should be carried out not only when it starts to hurt, but also undergo an examination for prevention (at least once a year).
Research types
The general scheme for the diagnosis of diseases in the rectum includes the following research methods:
Finger examination makes it possible to:
- to identify the general readiness of the intestine for further research;
- examine the condition of the intestinal tissue;
- check the general condition of the mucous layer of the lower part of the intestine (read more about the rectal mucosa);
- detect if there are any abnormalities in the intestine;
- choose a suitable position of the patient for further diagnostic procedures.
Rectal examination is carried out by digital examination, due to which the doctor can reveal the presence of inflammation and mobility of the affected intestinal mucosa.
The general technique for performing this procedure is as follows:
- the doctor inserts a finger into the rectum of the examined person;
- then palpation of the walls and examination of the mucous membrane are performed;
- at this time, the patient should lie quietly and relax the stomach as much as possible.
The big plus of this study is that there are no contraindications to it. For this reason, a rectal examination is done at the first suspicion of rectal disease.
- Anoscopy is a fairly popular examination method. This procedure is included in the list of the main diagnostic measures for lesions of the lower gastrointestinal tract.
Anoscopy is done using a special device - an anoscope. It is administered to the patient into the rectal cavity.
The advantage of anoscopy is that it enables the proctologist to examine the rectum for the presence of hemorrhoids up to a depth of 10 cm. The doctor can also learn about hemorrhoids and other diseases that have caused the dysfunction of this part.
Important! During pregnancy, rectal pain can indicate various disorders, so a woman is advised to adjust her diet and, just in case, diagnose the intestine.
The indications for this procedure are:
- the appearance of bloody discharge;
- chronic pain during bowel movements;
- suspicion of various diseases of the rectum;
- chronic constipation;
- discomfort in the anus.
The technique for performing anoscopy includes the following:
- the patient lies on his back;
- an anoscope is inserted into his anus;
- after that, the flaps of the device become wider, which makes it possible to improve the visibility of the intestine.
Contraindications to anoscopy are acute pain in the intestine and problems with stool.
- Sigmoidoscopy is an endoscopic examination. Today, such a technique is considered one of the most accurate, therefore it is mandatory for diagnostic or simply preventive examination.
This procedure makes it possible to see the general condition of the rectum with a depth of 10 to 30 cm. Due to the fact that it can cause discomfort in a person, such a study is carried out using anesthesia.
Indications for sigmoidoscopy are:
- severe pain in the rectum;
- the appearance of unpleasant discharge from the anus.
The research technique is as follows:
- the patient stands on the couch, leaning on his elbows and knees (this is the position that will facilitate the passage of the rectoscope through the intestine);
- then the rectoscope is lubricated with petroleum jelly, and is inserted through the anal canal along the intestine by 5 cm;
- then the tube is introduced into the intestinal lumen.
This procedure has no direct contraindications, however, this study can be difficult to do in case of acute inflammation of the abdominal cavity and bleeding from the anal canal.
- Irrigoscopy is an X-ray method for diagnosing the rectum. It is carried out by filling it with a barium solution, which is introduced through the anus.
Pictures are taken with the patient's lateral position. This procedure is prescribed for suspected fistulas or oncological pathologies.
Direct contraindications to MRI are:
- the presence of an installed pacemaker;
- the presence of metal implants in the body;
- the presence of hemostatic clips in the vessels of the brain.
Additional contraindications are:
- pregnancy and the period of breastfeeding;
- heart diseases;
- claustrophobia;
- the presence of tattoos, which are made using dyes containing metal.
The general technique for carrying out this procedure provides for the following:
- the patient lies on his left side with knees pulled up to the chest;
- then the doctor does anesthesia of the anus and inserts a special device into the rectum;
- slowly he further passes through the intestinal cavity (the supplied air stream helps him with this);
- on the screen, the doctor sees all the changes and violations of the intestinal walls.
In order to avoid unpleasant sensations, during an ultrasound examination, the patient must follow all medical recommendations. Also, in this case, a person may be disturbed by the urge to use the toilet, but they just need to endure.
During the examination, the patient may experience discomfort and even pain. After the procedure, it is advisable for the patient to lie down for several hours.
Important! Timely diagnostics significantly increases the chance of a speedy recovery.
Anton palaznikov
Gastroenterologist, therapist
Work experience over 7 years.
Professional skills: diagnostics and treatment of diseases of the gastrointestinal tract and biliary system.
Rectal cancer- a malignant tumor that forms in the mucous membrane of the end section of the large intestine. Often among doctors, the term "colorectal cancer" is used, which includes all tumors of the colon, including the rectum.
Among all tumors of the gastrointestinal tract, rectal cancer is 45%.
5% of patients with cancer suffer from this particular tumor.
In Russia, the prevalence of rectal cancer is constantly increasing. The highest frequency is observed in St. Petersburg and the Leningrad region, in Pskov. More than 50,000 new cases of this tumor are detected in our country every year. Between the ages of 30 and 50, the incidence of rectal cancer has declined slightly in recent years, while in older people it is steadily increasing.
World statistics
Most often, residents of developed industrial countries and large cities get sick. In the first place - the USA, Canada, Japan. In India and China, the prevalence of pathology is on average 15 times lower. Every year in the world, rectal cancer is diagnosed in 600,000 patients.Rectal cancer mortality is on the rise. Every 10 years it increases by 15% - 20%. Often the disease is detected at a later date, when many methods of treatment are ineffective.
Survival statistics for rectal cancer patients:
- In developed countries, about 60% of patients survive within 5 years from the date of detection of the pathology.
- In developing countries, this figure is no more than 40%.
Rectum anatomy
Rectum- this is the final section of the intestine. It ends with an anal opening, designed to remove feces outside. Its length in an adult is from 15 to 20 cm. The main wide part of the rectum - the ampulla - is located in the pelvic cavity and is surrounded by fatty tissue. The final short segment, the anal canal, or anus, is located in the pelvic floor (muscles and soft tissues that limit the pelvis from below) and is surrounded by a sphincter muscle (constrictor).The rectal mucosa contains a large number of mucus-secreting cells. It acts as a lubricant for the passage of feces. The mucous membrane is collected in folds in the form of vertical pillars and a crescent shape.
In the lower part, the rectum is surrounded on the outside by a hemorrhoidal plexus, consisting of a large number of wide veins.
Rectal cancer causes
Factors contributing to the development of malignant tumors of the rectum:- Power features... Rectal cancer is much more common in people who consume large amounts of meat, especially beef and pork. Meat food, entering the intestines, stimulates the multiplication of bacteria that produce carcinogens. A decrease in plant fiber in the diet also increases the risk of developing pathology.
- Hypovitaminosis... Vitamins A, C and E inactivate carcinogens that enter the intestines. With their lack in food, the harmful effects on the wall of the rectum and the entire colon increase.
- Overweight... Rectal cancer has been proven to be the most common in obese people.
- Sedentary lifestyle... With constant sedentary work, blood stagnates in the veins of the pelvis and hemorrhoids. This leads to dysfunction of the rectal mucosa and increases the likelihood of developing malignant tumors.
- Heavy smoking... Statistical studies show that smokers have this type of malignant tumor more often than non-smokers. Apparently, this is due to the effect of nicotine on blood vessels.
- Alcohol abuse... Ethyl alcohol irritates the intestinal wall, damages the mucous membrane, and promotes the formation of cancer cells.
- Occupational hazards... Rectal cancer is common among workers who have to come into contact with indole, skatole and other harmful substances. Colon cancers are common in cement and sawmill workers.
- Heredity... A person whose relatives have suffered from this disease has increased risks. They are the higher, the closer the degree of kinship.
Precancerous diseases, against the background of which malignant tumors of the rectum most often occur:- Polyps... These are benign formations of the mucous membrane, which are elevations. The risk of malignancy is especially high if the polyp is more than 1 cm in size.
- Diffuse polyposis- a hereditary family disease in which a large number of polyps form in the rectum and colon.
- Papillomavirus infection in the anus- papillomaviruses are capable of causing cell mutations leading to the development of malignant tumors.
Until now, the mechanism of development of rectal cancer has been insufficiently studied.
Rectal cancer symptoms
Factors on which the symptoms of rectal cancer depend:- tumor size
- the duration of the course of the disease
- tumor site
- growth pattern of a malignant neoplasm
| Symptom | Description |
| Discharge of blood from the anus. |
|
| Discharge from the rectum of pus and mucus. |
|
| Bowel disorders |
Disorders of bowel function in rectal cancer occupy the second place in terms of occurrence after bleeding. |
| Intestinal obstruction |
|
| Rectal pain |
|
| Violation of the general condition |
|
Rectal cancer diagnostics
Patient interview
Points that the doctor should find out when interviewing a patient:- existing complaints and the time of their appearance;
- the nature of the diet, bad habits;
- anamnesis: has the patient ever had polyps or other precancerous diseases, has he already undergone treatment for tumors of the rectum or other organs?
- family history: have relatives suffered from rectal cancer and other precancerous diseases?
- place of work: does the patient have to come into contact with hazardous substances?
Digital examination and examination of the rectum in rectal mirrors
Finger examination- the simplest method by which a proctologist (specialist in rectal diseases) can identify pathological masses in the rectum. The doctor asks the patient to stand in a knee-elbow position (on all fours, leaning on the couch with his knees and elbows), puts on latex gloves, lubricates the index finger with petroleum jelly and inserts it into the rectum. The condition of its wall and the presence of pathological formations are assessed by touch. After a digital rectal examination, it is impossible to establish a diagnosis of a malignant tumor. But if any formation is found, the doctor is obliged to prescribe a further examination to confirm or deny cancer.
A rectal speculum is an instrument that consists of two leaves and two handles. The examination is also carried out in the knee-elbow position. The doctor inserts the mirror into the anus, while its flaps are in the closed position. By pressing the handles, the proctologist gently pushes the flaps apart, making the intestinal lumen accessible for examination. After examination with a rectal speculum, the presence of rectal cancer is more likely to be assumed, but the final diagnosis must be confirmed by other, more informative, methods.
Instrumental research methods
| Research method | Description |
| Sigmoidoscopy | Endoscopic examination. Done with sigmoidoscope- a device consisting of a tube with a lighting device and a device for pumping air. How is the research done? Before sigmoidoscopy, the patient is asked to take one of two positions:
 The doctor inserts a rectoscope into the anus, pumps a certain amount of air into the rectum to expand its lumen, and examines its mucous membrane. What can be found during the pro-romanoscopy?
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| Irrigography – X-ray contrast study of the rectum and colon | Irrigography- X-rays of the rectum, taken after a contrast agent (suspension of barium sulfate) has been injected into it. Irrigoscopy- X-ray examination, in which the rectum filled with contrast is examined in real time on the screen. Preparation for research:
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| Ultrasound examination (ultrasound) | What helps to identify ultrasound in rectal cancer:
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| CT scan |  Most often, computed tomography for rectal cancer is prescribed if, after ultrasound and X-ray studies, conflicting data are obtained. During computed tomography, images are obtained, which are layer-by-layer slices of the pelvic region. They clearly show the rectum and adjacent organs. |
| Additional instrumental research methods for detecting metastases of rectal cancer |
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| Plain radiography of the abdominal cavity. | X-rays of the abdomen are taken without the introduction of contrast. The study allows you to assess the condition of the intestines, to identify intestinal obstruction. |
| Fibrocolonoscopy | A study in which a long, thin endoscope is inserted through the rectum into the overlying sections of the large intestine. Fibrocolonoscopy reveals the spread of a malignant tumor to the wall of the sigmoid and colon, the presence of polyps capable of malignant degeneration.   |
| Radioisotope liver scan | Rectal cancer often metastases to the liver. If there is a suspicion of its defeat, a radioisotope scan is performed. The patient is injected intravenously with isotopes, which are captured and accumulated by tumor cells. Then the pictures are taken. |
| Laparoscopy |   Endoscopic examination, in which miniature video cameras are inserted into the abdominal cavity through punctures in the abdominal wall. The study is equivalent to an operation and is performed under general anesthesia. Laparoscopy makes it possible for all internal organs to assess their condition and the degree of metastatic lesions. The doctor has the opportunity to take material for examination under a microscope (biopsy). |
| Intravenous urography | X-ray contrast study, in which a solution of contrast agent is injected intravenously. It is present for some time in the blood, and then it is excreted through the kidneys, ureters and bladder, staining them. On the pictures, you can assess the condition of these organs, the presence of metastases in them. |
Laboratory research methods for rectal cancer
Tumor markers
Tumor markers are specific substances, the content of which in the blood increases with different types of malignant tumors. To conduct a study, blood is taken from a vein for analysis.Tumor markers specific to rectal cancer:
- CA 19-9- a substance that is secreted by tumor cells of the colon and rectum. It helps to identify not only the tumor itself, but also metastases at an early stage.
- Cancer embryonic antigen... This substance is produced in the digestive system of embryos and fetuses. In healthy adults, it is practically not detected in the blood. Its level is increased in malignant intestinal tumors.
Determination of tumor markers in the blood is important only as part of a comprehensive examination. By itself, performed in isolation, it does not allow for an accurate diagnosis of rectal cancer.
Biopsy
Biopsy Is one of the most accurate methods for diagnosing rectal cancer. It allows you to reliably establish a diagnosis and distinguish a malignant tumor from a benign neoplasm. To conduct the study, the doctor takes a small fragment of the tumor during sigmoidoscopy. The procedure is usually completely painless for the patient.The material obtained during a biopsy can be subjected to histological and cytological examination.
Procedures during which material from the rectum and adjacent organs may be taken for biopsy:
- sigmoidoscopy;
- surgery for rectal cancer;
Histological examination
During histological examination, a sample of rectal tissue is examined under a microscope. Types of histological examination of rectal tissue:
- Urgent... Performed within 30 - 40 minutes. It is carried out if the result is needed quickly, especially in hospitals. The material is frozen, processed with special dyes, after which it can be studied under a microscope.
- Planned... Takes 5 days or more. The tissue obtained during the re-romanoscopy is treated with a special solution and paraffin, and dyed. This is a more complex process than freezing, but produces more accurate results.
Cytological examination
Cytological research is the study of the structure of cells, the identification of their malignant transformation. Unlike histological examination, in cytology, not a tissue section is examined under a microscope, but individual cells.Materials for cytological research:
- a piece of rectal tissue obtained during a biopsy;
- pus, mucus from the lumen of the rectum;
- imprints of the rectal mucosa.
Rectal cancer types
Classification of malignant tumors of the rectum depending on the cellular structure
Rectal cancer symptoms depend little on histological structure of the tumor(the type of cells that are part of its composition and the structure of the tissue). This factor determines the behavior of the tumor, the rate and nature of its growth, affects the specificity of treatment and prognosis.
Types of rectal tumors depending on the histological structure:
- Adenocarcinoma... The most common type of malignant tumors of the rectum. Revealed in 75% - 80%. Formed from glandular tissue, it is most often found in persons over 50 years of age. When examined under a microscope, it is possible to reveal the degree of differentiation of the tumor tissue. Distinguish between highly differentiated, moderately differentiated, low differentiated and undifferentiated tumors. The lower the degree of differentiation, the more malignant the tumor is, the worse the prognosis for the patient.
- Signet ring cell carcinoma... It occurs in 3% - 4% of cases. It got its name from the characteristic appearance of tumor cells under a microscope: there is a lumen in the center of the cell, and a narrow rim with a cell nucleus at the periphery - it resembles a ring with a stone. This type of rectal cancer has an unfavorable course, many patients die within the first three years.
- Solid rectal cancer... Rare. Comes from glandular tissue. It consists of poorly differentiated cells, which no longer look like glandular cells and are located in the form of layers.
- Skinny cancer (skyr)- also a rare type of malignant tumor of the rectum. It has relatively few cells and a relatively large amount of intercellular substance.
- Squamous cell carcinoma... The third most common (after adenocarcinoma and cricoid cell carcinoma) is a malignant tumor of the rectum - it is 2% - 5% of the total. This type of tumor is prone to early metastasis. Often its occurrence is associated with human papillomavirus infection. Found almost only in the lower part of the rectum, in the anal canal.
- Melanoma... Tumor from pigment cells - melanocytes. Located in the anal canal. Prone to metastasis.
Classification of rectal cancer depending on the nature of growth
- Exophytic cancer... The tumor grows outward, into the lumen of the rectum.
- Endophytic cancer... The tumor grows inward, grows into the wall of the rectum.
- Mixed form... It is characterized by both exophytic and endophytic growth.
TNM classification of rectal cancer
This classification is the main one. The stage of the TNM tumor must be indicated in the patient's medical record after diagnosis.Explanation of the abbreviation:
- T is the size of the tumor (tumor);
- N - metastases to nearby lymph nodes (nodus);
- M - distant metastases in various organs (metastasis).
| Designation | Description |
| Tx | The size of the tumor has not been specified, and the necessary data are lacking. |
| T 0 | The tumor was not found. |
| T is | The tumor is in situ - "in place", small in size, does not grow into the wall of the organ. |
| T 1 | The tumor is up to 2 cm in size. |
| T 2 | The tumor is 2 - 5 cm in size. |
| T 3 | The tumor is larger than 5 cm. |
| T 4 | A tumor of any size that grows into neighboring organs: the bladder, uterus and vagina, prostate gland, etc. |
| N x | There is no data. It is not known if there are lymph node metastases. |
| N 0 | There are no lymph node metastases. |
| N 1 | Metastases in the lymph nodes located around the rectum. |
| N 2 | Metastases in lymph nodes located in the groin and iliac region on one side. |
| N 3 |
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| M x | It is not known whether there are distant metastases in the organs. Insufficient data. |
| M 0 | There are no distant metastases in the organs. |
| M 1 | There are distant metastases in the organs. |
Rectal cancer stages according to classificationTNM:
| Stage | TNM classification |
| Stage 0 | T is N 0 M 0 |
| Stage I | T 1 N 0 M 0 |
| Stage II | T 2-3 N 0 M 0 |
| Stage IIIA |
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| Stage IIIB |
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| Stage IV | T any N any M 1 |
The condition of a patient with rectal cancer depends on the presence or absence of metastases.
- If the tumor is located within the rectum, then the patient is concerned only with digestive disorders, pain in the intestine, admixture of pus, blood and mucus in the feces.
- If a tumor grows into neighboring organs, then symptoms characteristic of their defeat arise. When germinating into the uterus and vagina - pain in the lower abdomen, violation of menstruation. When germinating into the bladder - pain in the lower abdomen, urinary disorders. With the spread of metastases in the liver - jaundice, pain under the rib.
- With multiple metastases, the general condition of the patient is disturbed: weakness, increased fatigue, exhaustion, anemia, and increased body temperature occur.
Rectal cancer treatment
Rectal cancer surgery
Surgical treatment is the main one for malignant tumors of the rectum. Other methods are used to complement it. Rectal surgeries are among the most traumatic. Today, new techniques have been developed that allow maintaining the normal act of defecation and avoiding common postoperative complications.
Factors influencing the choice of surgical technique:
- the size and location of the tumor;
- the nature of the cellular structure of the malignant neoplasm;
- classification of a tumor according to the TNM system.
| Operation type | Description |
| Resection of the rectal sector and anal sphincter (constrictor muscle) | The essence of the method: Part of the lower rectum and anal sphincter is removed. After that, they are completely restored. Indications: A tumor located in the anal canal and sphincter, occupying less than 1/3 of their circumference, not growing beyond the rectum. |
| Resection (removal of part) of the rectum | Method essence: The surgeon removes part of the rectum, and the rest, located above, sutures to the anal canal. Indications: A malignant tumor located in the lower part of the rectum, but above the anal canal, at stage T 1 N 0. |
| Typical abdominal anal resection. | Method essence: The rectum is removed while preserving the anal canal and anal sphincters. Sigmoid colon(which is located above the straight line) is lowered down and sutured to the sphincter. Indications:
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| Abdominal anal resection with removal of the internal sphincter (muscle pulp) | Method essence: The operation is very similar to the previous one. In this case, the surgeon removes, together with the intestine, the internal sphincter located in the anal canal. A new artificial sphincter is created from the muscle layer of the sigmoid colon descending downward. Indications: To carry out this type of surgical intervention, the following conditions must be met:
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| Abdominal perineal extirpation (removal) of the rectum with releasing into the wound of the sigmoid or colon. | Method essence: The surgeon removes the entire rectum. In its place, the end of the sigmoid colon is lowered down. In the area of the anus, an artificial muscle cuff is created, which should play the role of a pulp. Indications: To carry out this type of surgical intervention, the following conditions must be met:
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| Abdominal perineal extirpation (removal) of the rectum with the formation of an intestinal reservoir | Method essence: The surgeon removes the entire rectum and anal canal. The sigmoid colon is pulled down. Features of the operation:
This type of surgical intervention is carried out at the stage of the tumor T 1-2 N 0, with its large length. |
| Typical abdominal perineal extirpation (removal) of the rectum. | The essence of the method: The rectum and anal canal with the sphincter are completely removed. The free end of the sigmoid colon is brought out onto the skin on the anterior surface of the abdomen (colostomy). Indications: This surgery is performed at tumor stage T 3-4 N0-2.
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| Evisceration of the pelvis | Method essence: Removal of all affected organs from the pelvic cavity: rectum, uterus, ovaries and vagina, seminal vesicles, prostate, ureters, bladder, urethra, lymph nodes and part of adipose tissue. Indications: This surgery is performed when the tumor spreads to the lymph nodes and grows into neighboring organs. Stage - T 4 N 0-2 |
| Imposition of a double-barreled colostomy | The essence of the method: The rectum is not removed. A hole is made in the wall of the sigmoid or colon, and is brought out onto the skin of the anterior surface of the abdominal wall. Indications:
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Radiation therapy for rectal cancer
Indications for radiation therapy for malignant rectal tumors:
- Preoperative period... The sessions are held daily for 5 days. The area where the tumor is located is irradiated directly. Surgical treatment is performed 3 - 5 days after the end of the course.
- Postoperative period... The course of radiation therapy begins 20-30 days after the operation, if metastases to regional lymph nodes have been confirmed. The tumor area and all lymph nodes of the pelvic region are irradiated. The sessions are held daily 5 days a week.
Late complications of radiation therapy for rectal cancer:
- atrophy(decrease in size and dysfunction) of internal organs: bladder, uterus, ureters, vagina, prostate, etc.
- necrosis(necrosis of) bones.
Chemotherapy for rectal cancer
Chemotherapy is prescribed as an adjunct to surgery for rectal cancer in the postoperative period.| A drug | Description | How is it applied | Complications and methods of dealing with them | |
| 5-fluorouracil | This substance accumulates in tumor tissue, blocks the synthesis of DNA and RNA, and inhibits the multiplication of cancer cells. | Solution for intravenous administration. It is prescribed at 500 - 600 mg / m 2 of body surface daily for 5 days or every other day. The total dosage for the course is 4 - 5 days. | The most pronounced negative effect of fluorouracil on the state of the red bone marrow and the digestive system. Symptoms:
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| Ftorafur | The active ingredient is Tegafur. It accumulates in tumor cells and inhibits the enzymes responsible for the synthesis of DNA and RNA, suppressing their reproduction. | Prescribe the drug intake or intravenous administration daily at a dosage of 0.8 - 1.0 g / m 2 of body surface per day. The total dose for the course is 30 g. | Like fluorouracil | |
| Polychemotherapy is a combination of different drugs. |
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Treatment with this combination begins 56 days after surgery. | Adriamycin:
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How do I look after my patients?
Patients who need special care:- recent surgery for rectal cancer;
- emaciated, in serious condition;
- having a colostomy: the end of the intestine brought out to the skin of the anterior surface of the abdomen.
- frequent change of underwear and bed linen;
- it is necessary to ensure that crumbs and dirt do not accumulate on the sheet;
- prevention of bedsores: the patient must be periodically turned over, change his position in bed, you can use anti-bedsore mattresses;
- treatment of bedsores with camphor alcohol;
- feeding the patient (if the patient cannot eat on his own, then a special probe is used);
- hygiene procedures: daily washing, brushing teeth, periodically washing the body with a damp sponge;
- delivery of the vessel;
- for fecal and urinary incontinence, special diapers and pads are used.
Colostomy patients wear a special colostomy bag. The main care is associated with its periodic replacement. This can be done by the patient or the caregiver. 
Colostomy bag replacement:
- carefully remove the used colostomy bag (most often they use adhesive ones - with a special sticker) from top to bottom, throw it away;
- wipe the skin around the colostomy dry with a paper or gauze napkin;
- rinse the colostomy and the skin around it with warm boiled water;
- dry the skin thoroughly with napkins;
- lubricate the cream with an ointment or paste prescribed by a doctor;
- remove the remnants of the cream from the skin with a napkin;
- glue a new colostomy bag to the skin, following the manufacturer's instructions attached to it.
Diet for rectal cancer
Nutritional rules for rectal cancer:- good nutrition, the inclusion in the diet of a sufficient amount of proteins, fats, carbohydrates, vitamins and minerals;
- limiting fatty meat foods;
- enrichment of the diet with vegetables and fruits;
- full breakfast;
- five meals a day in small portions;
- thorough chewing of food;
- exclusion from the diet of spicy, sour, extractive foods.
Rectal cancer prognosis
Factors affecting the prognosis in malignant neoplasms of the rectum:- stage of the disease;
- the cellular structure of the tumor;
- the degree of differentiation of tumor cells (undifferentiated ones are the least favorable - see above);
- the presence of metastases in the lymph nodes;
- type of treatment performed.
Dependence of the number of patients who survived for 5 years on the stage of the tumor process:
- Stage I - 80%;
- Stage II - 75%;
- IIIA stage - 50%;
- IIIB stage - 40%.
Rectal cancer prevention
General preventive measures to prevent rectal cancer:- Proper nutrition. Restriction in the diet of meat and fatty foods.
- Adequate physical activity, the fight against excess body weight.
- Timely treatment of rectal diseases: anal fissures, hemorrhoids, polyps, etc.
- Quitting bad habits: alcohol, smoking.
- analysis of feces for occult blood;
- sigmoidoscopy;
- ultrasonography.
The diameter of the rectum varies in different ways (2.5 - 7.5 centimeters). The rectum begins from the sigmoid colon, only at the end it ends with an opening - it is called anal.
In fact, the rectum is not straight, since it has two bends, and they are located in the longitudinal plane. The very first bend is called sacral. This bend is concave towards the sacrum and ends in a bulge at the back. The second bend is called the perineal bend, since its bulge is directed forward and it most directly represents the bend of the intestine through the coccyx.
Rectum sections
The rectum can be divided into three different sections. The lowest and narrowest is called the perineal, in other words, it can be called the anal canal. It is this channel that performs the function of opening outward (anus). Its length is only 2-4 centimeters.
The broadest part in the rectum is located above the anal canal, its length ranges from 10 to 12 centimeters, it is called the ampulla. The third section of the rectum is called "nadampular", in comparison with the ampoule, this section is small, only 5-6 centimeters long.
Coccyx
The tailbone is located directly behind the rectum, and there is also a sacrum. In front of the rectum in men in this area are the ampullae of the vas deferens, the prostate gland, seminal vesicles and, of course, the bladder. In women, the uterus and vagina are located in this area. In the figures, you can remarkably see the difference in how the rectum and nearby organs are located.
Rectum protection
Several layers of protection are located on the walls of the rectum itself. As we have already said, the upper part - it is supramidal, is under the reliable protection of the peritoneum - a thin and very transparent film (shell) on the outside. The anal and ampullar canals are covered with reliable layers formed from fats and connective fibers, it does not apply to the peritoneum.
The rectum also has a middle layer, which is firmly protected by a couple of rows of muscles. The muscle fibers are outside (they are longitudinal). And the longitudinal muscle fibers inside contain circular fibers of the same composition, which are called the internal sphincter, it is also called pulp, and are surrounded by the external sphincter, so that the fecal masses are closed and do not fall out prematurely.
The sphincter fibers are securely interconnected and attached in a circular manner to the anus.
Rectal mucosa
The mucous membrane is called the wall of the rectum (inner wall). The incredibly thin layers of the mucous membrane are detached from the muscle layer. It is thanks to these ultrathin layers that the muscular mobility of the connective tissues is formed.
Cylindrical epithelial cells form the rectal mucosa. They also consist of intestinal glands, they are called mucous and goblet. They have the ability to secrete a secret in the form of mucus. It is designed to prevent wounds, scratches and other damage to the walls of the rectum when stool passes through it. The mucus also lubricates the stool, which travels more quickly through the rectum. Follicles - small lymphoid nodules - are also found in the rectum.
Rectal folds
When the rectum is not filled with feces, its mucous membrane is capable of forming folds - there are many of them, and they go in different directions. Two or three folds of the rectum run across, next to them are the fibers of the muscle layer, which run in a circle. Their course is obtained in the form of a screw, and they are located in the ampulla of the rectum. There are also other folds that are not permanent, they are longitudinal, and straighten when the intestine is full.
In the area of the anus, the mucous membrane forms more folds - there are from 6 to 10 of them. These folds are permanent, they are called funny - anal columns. They are located at the anus and have an elevation in the form of a ring at their base. Here is the place where the rectal mucosa forms a transition into the skin of the anus - anus.
Rectal blood supply system
To have a clear idea of what causes hemorrhoids, it is important to understand how the blood supply to the rectum works. The fact is that hemorrhoids are a disease that affects the blood vessels located in the submucosal layer of the rectum. It is because of the violation of their structure and work that a person suffers from pain in the anus.
The work of the five arteries
Five arteries work to start blood flow into the rectum. Rather, not into the intestine itself, but to it, to its submucous layer. One of these arteries is not a paired artery, it is located at the top and is called so - hemorrhoidal. This artery is the end of a lower artery called the mesenteric artery.
So, the hemorrhoidal artery has an important role - it carries blood flow to the back wall of the rectum. These are the areas located above the ampoule and in the part of the ampoule (we have already spoken about them).
But there are 4 more arteries that carry blood to the rectum. They make pairs. These pairs are located on the right and left, in the middle and at the bottom of the rectum. They end in the hypogastric arteries.
These arteries do not work by themselves - they constitute a single whole network of arteries that work harmoniously for the benefit of our body. The arteries are interconnected vertically and horizontally in the walls of the rectum.
Rectal venous system
This is a very important system that ensures the outflow of blood flowing through the veins in the rectum. The blood runs from smaller wreaths to larger ones, then runs along the arteries.
Where is the network of veins in the rectum? Its location is in the layer called the submucosa (we already know about it). The most solid section of the rectum is the final one, in which the arteries and veins do not branch out to the smallest capillaries, but stretch directly to the so-called anal columns. From this, cavernous bodies are formed in the rectum, located under the mucous membrane. These bodies are also called cavernous.
When a person develops hemorrhoids, it is these cavernous bodies that swell and cause pain reflexes in a person, sometimes unbearable. This is the anatomical features of the rectum.
Why do bumps appear in the anus with hemorrhoids?
And it is just the cavernous or cavernous bodies that swell. They are permeated with many tiny wreaths that look like bunches of grapes. When blood accumulates in them, the "grapes" swell and grow. Approximately how the phallus swells during an erection. And then the walls of these cavernous bodies cannot withstand the flow of blood and can burst, be damaged, stretch, and, of course, hurt a lot.
Then the person complains of bleeding from the anus. To avoid or stop it, you need anti-inflammatory drugs that will remove the inflammatory process in the corpora cavernosa, and at the same time the pain. In the meantime, you need to remember that when hemorrhoids occur, the blood from the anus is not dark, but scarlet, because in the cavernous bodies it is just like that due to the accumulation of oxygen.
Role of the corpora cavernosa
Their role is not only to cause us trouble when hemorrhoids attack the body. As long as doctors have not studied the human body, they have not yet fully understood what roles the corpora cavernosa perform, except for the accumulation of blood. They are known to help the sphincter retain stool by performing an additional clamping function.
The corpora cavernosa, like the appendix, are similar to a rudiment in the human body. They are found even in babies who have just been born, so the body needs them, maybe even for those roles that we do not yet know about.
Rectal nerves
There are a lot of nerve endings in the rectum. Like spies that form their own network, the fibers of the parasympathetic and sympathetic nervous systems are located in it. This is how nature conceived anatomically, since there are many reflexogenic zones in the rectum, and signals along these zones are transmitted from the cerebral cortex.
When a boy or girl is born, their rectum is cylindrical, has no bends or ampullae, and the folds of the intestine are not very pronounced.
The length of the rectum of a newborn child is up to 6 cm, at least 5 cm. The anal columns of small children are very well developed. The ampulla finishes forming before the age of 8 years. And then the rectum forms bends. When a child reaches 8 years old, not only bends form in the rectum - it generally begins to grow very quickly, lengthen and by the age of 14 it becomes more than three times longer - from 15 to 18 centimeters. And the diameter of the rectum in adolescence is from 3.2 cm to 5.4 cm.
When a person gets older and reaches the age of 50-60 years, his rectum lengthens even more, the bends are no longer so clear, they lose their direction, and the rectal mucosa becomes much thinner. At the same time, the cavernous (cavernous) bodies become thin, empty, therefore, hemorrhoids in men and women over 60-65 years old are very rare.
The rectum's job of removing toxins
When the rectum works, it powers the digestive system as a whole. The rectum does the job of eliminating toxins from the body and all unnecessary substances that are no longer needed there.
When a lot of unnecessary toxins accumulate in the rectum, they need to be removed from there. And if the rectum does not work properly, these rotten and fetid masses will accumulate there, poisoning the entire body. That is why it is so important that the rectum is healthy and performs all its functions of evacuating substances unnecessary to the body.
The statistical role of the rectum
There are major roles for the rectum. There are two main roles. One is statistical, the other is dynamic. The statistical role of the rectum suggests that it will accumulate and retain intestinal feces.
If the stool is normal, it will be a uniform brown color. It is dense, shades of brown can vary. In the composition of normal feces, 30% of food remains, and water - 70%. Among the food debris are intestinal epithelial cells along with dead bacteria. The mass of feces of a healthy person per day will not exceed 350 grams.
When fecal matter builds up in the rectum, it can become wider and the folds of the rectum (its mucous membrane) straighten out. The feces are held in the rectum by means of an anal pulp, because the walls of the anus are tightly compressed. The anal sphincter is designed to prevent the contents of the intestine from spilling out of it on its own and gas is not released involuntarily.
Sphincter strength
The anal sphincter is a very powerful and strong muscle. Scientific studies prove that in a healthy person, the strength of the sphincter is such that at rest it reaches 550 grams, and when it contracts, then with maximum compression, this force increases to 850 grams.
When a person is worried about hemorrhoids or other diseases of the rectum, this is immediately reflected in the strength of the sphincter. It becomes almost four times weaker - the force of its compression reaches only from 200 to 300 grams instead of 850. And then the contents of the intestine can come out spontaneously, and this happens during the most common everyday activities - coughing, squatting, laughing, sneezing, simple walking ... In addition to feces, gases, liquid feces do not hold in the rectum, and this unpleasant process is constant - as long as the rectum is unhealthy.
The dynamic role of the rectum
This role is no less important than the first - statistical. It is characterized by the peculiarity of the rectum to evacuate out of the body what it does not need: feces, foreign substances. Namely, thanks to the dynamic function of the rectum, a person is able to defecate. This is a rather complex physiological reflex process, which Academician Pavlov wrote about. He spoke in his lectures that the need for the process of bowel movement can be learned through the signals of the sensory nerves of the rectum.
This means that when the walls of the rectum are irritated by the feces that have accumulated there, a signal goes through the reflex endings that it is time to evacuate them from the rectum.
Sometimes it happens that a person feels the urge to evacuate feces from the rectum when it is empty. This means that there are malfunctions in her work. For example, with diseases such as ulcerative colitis, hemorrhoids, infections that have entered the intestines.
Muscles involved in bowel movements
Muscle fibers play the most direct role in the process of bowel movement. These muscle fibers are located on the intestinal walls. They are joined by the abdominal muscles, which we so stubbornly do not want to pump. But in vain: it would significantly strengthen the body, since human health depends on the success of the defecation process.
How does defecation work?
When the process of defecation begins, the person inhales deeply, this closes the glottis, and the sphincter of the anus weakens its press, relaxes, while the abdominal press strains. If the abdominal press is weak, a person will not be able to perform a normal act of defecation, he pushes for a long time, feces from the rectum may go weakly.
When a person takes a deep breath, the diaphragmatic muscle falls down, from this the abdominal cavity contracts, decreases in volume. At this time, a lot of pressure is created in the abdominal cavity, and the feces are thrown out through the anus. The pressure is so strong that it reaches 220 mm of water column pressure, which is more than one and a half times higher than the level of arterial pressure created by the blood flow.
The patterns of the act of defecation
The process of defecation, like any other processes occurring in the body, has its own laws. Scientists have tracked these patterns and found that there are two types of defecation: one-stage and two-stage.
During a one-time bowel movement, the rectum is able to throw out its contents in one go. If there is a two-stage bowel movement, then the feces are thrown out by the intestines not at one time, but in parts. This can take anywhere from three to seven minutes. So, with a two-stage ejection of feces, a person is forced to stay in the toilet for more than seven minutes, since with the first act of ejection of feces, he has the feeling that the process is not over.
Both the first and second types of bowel movements are normal and characteristic of humans - these are simply anatomical features that do not pose a health hazard, if we take into account the properties of their reduction.
Prolonged bowel movements
It so happens that a person cannot defecate for more than 15 minutes. Then the process is delayed up to half an hour. All this time, a person is trying to forcefully push the feces out of the rectum.
Instead of waiting, waiting for the next contraction of the intestinal walls and pushing out the stool in a time interval of 7-15 minutes, the person begins to panic and push them out, pushing. And then the constant tension in the abdominal press causes overstrain in the veins of the rectum, in particular - in the cavernous (cavernous) bodies already familiar to us.
]Bowel Type Statistics
Studies show that up to 70% of people experience simultaneous bowel movements. Then, up to 25% of people experience a two-stage defecation - there is no other way to put it. The rest of the people perform a mixed bowel movement.
There are exercises that allow a person to achieve a one-step, most convenient type of bowel movement. How to do them, you need to consult a proctologist.
As for patients with hemorrhoids, up to 90% of them suffer from the fact that they have a two-stage type of bowel movement. They need to be especially careful during bowel movements and use the natural processes inherent in the rectum, that is, the time of its contraction.
Why is self-medication dangerous?
Often a person does not pay attention to the type of his bowel movements and considers it to be just a simple inconvenience, not suspecting that he is causing irreparable harm to his body.
If a person suffers from constipation, if he develops hemorrhoids, do not self-medicate, because the rectum, with improperly selected methods, can become cracked from the inside or outside, bleeding can occur from the swollen corpora cavernosa, there may be a danger of retaining feces in the rectum and poisoning body toxins. Do not neglect these symptoms and go to the clinic at the first sign of pain and discomfort in the rectal area.
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