Rectal Trauma or Injury

Rectal trauma or injury can result in damage to the muscles and nerve fibers of the rectum. This can be permanent. This can result in the inability to hold your stool inside the lower large bowel (incontinence). Damage to the nerves may make it hard to know when you have to defecate. This leads to the colon getting larger. As a result, one can experience constant soiling.

Damage to the tissue around the rectum can also lead to bad infections. This is caused by getting stool into the blood and nearby tissues. Infection is a common problem. Repeated damage and infections can lead to scar formation and other troubles. All of this can make having a normal bowel movement difficult or impossible.

DIAGNOSIS

The diagnosis is made by physical exam. A diagnosis is also made by a procedure (sigmoidoscopic or colonoscopic exam) where your caregiver examines the lower part of the bowel and area injured. Your caregiver will use an instrument like a small telescope that can view the colon and rectum with direct vision.

TREATMENT

  • Less severe injuries may be treated with observation and perhaps antibiotics. These are medications to kill germs. If you are prescribed antibiotics, take them as directed for the full course.

  • You may have blood tests or cultures to see if you have come in contact with a sexually transmitted or communicable disease. Make sure you know how to get your test results.

  • More severe damage may be treated with irrigation and colostomy. A colostomy is bringing part of the large bowel up to the belly (abdominal wall). This allows the stool to drain into a colostomy bag. By doing this and bypassing the lower colon and rectal sphincter, it allows the rectum to heal.

  • Repair of the rectum and anal sphincters can be undertaken at a later time, if necessary.

HOME CARE INSTRUCTIONS

  • Abstain from any activity that causes further damage or pain to the rectal area.

  • A warm sitz bath may be used as directed by your caregiver for pain relief.

  • If sitting causes discomfort, an "inflatable doughnut" may be used. These can be purchased at a drugstore or medical supply store.

  • To reduce pain and straining with bowel movements, eat a high fiber diet with plenty of fruits and vegetables.

  • Use stool softeners as recommended by your caregiver. This is especially important if narcotic type of pain medications were prescribed. These can cause constipation.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have increasing pain that is not controlled by medication.

  • There is increased redness, swelling, bleeding, or drainage around or from the rectum or rectal area.

  • An oral temperature above 102° F (38.9° C) develops.

  • You develop chills or feel lethargic or "washed out."

  • You develop abdominal pain, nausea or vomiting.

  • You have bloody stools or bleeding from the rectum.

  • You are unable to have a bowel movement.

  • You develop any new problems you feel may be related to your present problem.

  • You have new problems because of your injuries.

  • You have problems that may be because of the medicine you are taking. The related problems could be a rash, itching, swelling, or trouble breathing.