Rectal problems in women

In this article, consultant colorectal and general surgeon Ms Santhini Jeyarajah explores the different rectal issues that can trouble women.

The rectum is the final portion of the large intestine between the colon and the anus. This is where waste excrement exits the body, aided by a network of muscles. There are a variety of issues and conditions that can affect the structure and function of the rectum in women, making it difficult to pass stool, control when stool is passed, or part of the rectum herniates or prolapses.

While everyone has a rectum regardless of sex or gender, women or people born as women have unique features, structures, and abilities that can influence the condition of their rectum. By having a uterus and vagina, going through the menstrual cycle and menopause, and by being capable of pregnancy and childbirth, their anatomy can sometimes make them more prone to rectal problems such as:

Bowel incontinence:

The inability to control bowel gas, liquid, or solid stool is an issue that can happen to anyone, but women may struggle more with this during pregnancy or menopause. Sometimes, this can be indicative of a more serious condition, but most of the time it can be handled simply with dietary modification.

Constipation:

Women are more likely to suffer from chronic constipation than men. This could be due to the influence of the monthly menstrual cycle, especially during the pre-menstrual period when the hormones progesterone and oestrogen fluctuate, making the body retain more salt and water. Women need to be cautious to not strain too hard when trying to pass stool as this can cause damage. Eating more fibre can help soften the stool, and there are also medicinal laxatives they can try.

On the other hand, women are likely to have softer and runnier stool during their period, as the hormones fluctuate in different ways once again.

Prolapse:

Women who are prone to vaginal prolapse are likely to also experience rectal prolapse. This is called rectocele. This is because the vagina and rectum share muscle walls that are likely to be weakened and stretched. Rectum

Prolapses can happen during pregnancy and childbirth due to pelvic strain, menopause, long-term constipation, having a hysterectomy due to the sudden empty space in the pelvis, or doing frequent heavy lifting. Most of the time, prolapses are not a cause of concern, and do not cause any pain, in which case it is encouraged to incorporate pelvic floor exercises and pessaries into your daily routine. But in cases where the prolapse is affecting the quality of life, then surgery to correct it can be considered.

Haemorrhoids:

Another rectal problem that can happen due to pregnancy, childbirth, and excessive strain is haemorrhoids. Similarly to a prolapse, haemorrhoids are when an internal part of the rectum, specifically blood vessels, comes out or becomes visible through the anus. They are also not particularly concerning, but there can be symptoms such as blood in the stool and discomfort when seated. Treatment options for haemorrhoids include creams and suppositories to alleviate swelling and itching, but for more intensive treatment, patients can explore options that cut off blood supply to the haemorrhoids to shrivel them up and cause them to retract. At the most extreme, a surgical procedure called a haemorrhoidectomy can be performed to excise them.

If you are suffering from rectal issues, you can consult with Ms Jeyarajah on Top Doctors today.