In modern medicine, rectal prolapse is characterized by the protrusion of rectal tissue, and the primary cause is considered to be the weakening of the pelvic floor muscles, surrounding ligaments, and tissues that support the anus and rectum. The concept of sinking of qi due to qi deficiency in Donguibogam can be seen as an intuitive explanation of this pelvic floor muscle weakness and the resulting visceroptosis. The pelvic floor muscles support the urinary bladder, uterus in women, and rectum from the lowest part of our body, functioning like a hammock to hold up the organs and playing a vital role in regulating defecation, urination, and sexual function. When these muscles weaken, the rectum deviates from its position and protrudes out of the anus.
The causes of pelvic floor muscle weakness are diverse. The habit of excessive straining in the bathroom due to chronic constipation or diarrhea increases intra-abdominal pressure, placing continuous pressure on the pelvic floor muscles and surrounding ligaments and causing them to stretch. It is also common for the pelvic floor muscles and nerves to become damaged or relaxed during pregnancy and childbirth. Additionally, the reduction of connective tissues such as collagen and elastin due to aging, loss of muscle mass, and decreased tissue elasticity caused by reduced estrogen after menopause are important causes. Obesity, chronic cough, and frequent heavy lifting can also raise intra-abdominal pressure, triggering or worsening rectal prolapse.
It can also be approached from a neurological perspective. The primary nerve regulating pelvic floor muscle function is the pudendal nerve, and when this nerve is damaged or its function declines, muscle control diminishes, which can lead to rectal prolapse. Chronic inflammation or specific medical conditions may also exert an influence. Recent studies reveal that the gut-brain axis and microbiome dysbiosis are closely related to intestinal motility, which can ultimately affect defecation habits and the burden placed on the pelvic floor muscles. Although modern medicine physically restores the prolapsed rectum through surgery, it emphasizes that strengthening the pelvic floor muscles and improving lifestyle habits are crucial for preventing recurrence.
