Causative factors

Causative factor for Guda bhramsha: (Prolapse of rectum)

Constant suppression of urges like urine and stool; importantly prolonged suppression of FAECES.
Injury to the rectal region - direct or indirect injury caused due to fall, surgery, entry of foreign body, perforation etc Constant diarrhoea - The individuals who suffer from constant diarrhoea or sprue syndrome suffer from weakness of the pelvic muscles, leading to prolapse of rectum over a period of years Constant constipation - leading to straining.
Frequent child births or abortions lead to laxity of the sphincters and muscles in nearby area. Weakness or malnutrition is another cause for prolapsed rectum as it leads to lessen the strength of the muscles and hence the withholding capacity of the nearby muscles. Repeated worm infestation causes constant irritation to the anal sphincters. Further, it reduces the strength of the sphincters.
Repeated surgeries and injuries also reduce the intactness of the muscles.
Multiple episodes of urinary calculi, gall bladder stones may also lead to prolapse of rectum or act as a supporting factor for the complaint.
Old age - In elderly people, due to age factor, muscles and sphincters become lax increasing the chances of prolapse. (The same is the reason for increased chances of hernia in elders).
Asthma, whooping cough, leading to constant pressure on ano-rectal muscles. Multiple sclerosis and paralysis.

Symptoms

• Repeating protrusion of rectum
• Painful defecation, initially
• Burning sensation, initially
• Backache
• Mucous discharge, blood discharge with visible protruded tissue
• Lack of urge to defecate

Treatment modalities of Rectal prolapse :

• The causative factors like constipation, diarrhoea, whooping cough, urinary calculi should be managed effectively.
• General condition and muscle strength of the patient should be improved with regular oil massage.
• The patient should be asked to take care regarding straining during defecation, over eating, repeated food, heavy food intake etc
• Tub bath - by Panchavalkala kashaya or Phalatrikadi kashaya is carried to build the strength of the anal sphincters and muscles.
• Medicines and treatments to strengthen anal muscles and sphincters. Rectal prolapse surgery, if all treatments fail.
• Medicines and treatments to strengthen anal muscles and sphincters. Rectal prolapse surgery, if all treatments fail.

Single herbs useful in Guda bhramsa [Prolapse of rectum ] :

• Changeri - Oxalis corniculata
• Lodhra-Symplocos racemosa - has astringent effect - absorbs excessive secretions, has binding properties.
• Lajjalu -Touch me not - very good wound healing herb
• Ashoka -Saraca asoka - useful in diarrhoea
• Haritaki -Chebulic myrobalan - useful in relieving constipation, wound healing.
• Draksha -Raisins - useful in constipation, improves muscle strength
• Chandana -Sandal wood - Has wound healing and astringent effect
• Kutaja -Kurch/Holarrhena tree - useful in excessive diarrhoea.
• Bola-Commiphora myrrh - Useful to stop bleeding and sanitise the area. Ayurvedic medicines

Ayurvedic medicines indicated in Guda bhramsha: (prolapse of the rectum )

In initial stages, rectal prolapse treatment without surgery can be done with following medicine options.

• Changeri ghrita - useful in bloating, malabsorption syndrome, diarrhoea, dysuria, piles.
• Mushika taila - This oil is applied to the prolapsed part, it is placed in its normal position and bandaging is done. - Treatment may be required for 2 - 4 weeks of time.
• Triphala choorna - Useful in wound healing, has astringent effect.
• Lodhrasava - Useful in piles, anaemia, heavy bleeding
• Ashokarisata - Useful in Pain menstruation, heavy periods, fever, bleeding disorders such as nasal bleeding, bleeding haemorrhoids, inflammation, etc
• Kutajarishta - useful in fever, sprue, diarrhoea etc
• Bola parpati - Useful in bleeding disorders, bleeding haemorrhoids.
• Aravindasava - useful in children, to improve digestion and muscle strength
• Chandanasava - Useful in improving blood circulation
• Manibhadra guda - Useful in piles, intestinal worms, cough etc.

Tips

Avoid constant straining during defecation. If you have constipation, seek medical advice and get it solved.
Constipation or diarrhoea should be treated immediately. If it becomes habitual, 30 - 35 % chance are there to go towards prolapse of rectum in due course of time.
Take enough caution after surgeries so as to pass the bowel regularly.