Cap-assisted endoscopic sclerotherapy is effective for rectal mucosal prolapse associated outlet obstructive...

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Endoscopic Procedures

Background:

• Outlet obstructive constipation (OOC) is a prevalent form of chronic constipation often linked to internal hemorrhoids (IH) and rectal mucosal prolapse (RMP).
• Cap-assisted endoscopic sclerotherapy (CAES) has shown promise in managing IH and RMP, suggesting potential for OOC treatment.

Purpose of the Study:

• To evaluate the efficacy of Cap-assisted endoscopic sclerotherapy (CAES) in treating patients with outlet obstructive constipation (OOC) associated with internal hemorrhoids (IH) and rectal mucosal prolapse (RMP).

Main Methods:

• Thirty-one patients diagnosed with OOC underwent CAES for IH and RMP.
• Anorectal manometry (AM), Wexner constipation score (WCS), self-rating anxiety scale (SAS), and self-rating depression scale (SDS) were assessed pre- and post-treatment.
• Follow-up assessments were conducted to evaluate treatment outcomes.

Main Results:

• CAES significantly improved subjective measures including bowel movement frequency, defecation time, WCS, SAS, and SDS.
• Anorectal manometry revealed significant improvements in anal relaxation rate, maximum squeeze pressure, and rectal residual pressure post-CAES.
• The proportion of patients with Bristol stool form scale types III-V increased substantially, indicating improved stool consistency.

Conclusions:

• Cap-assisted endoscopic sclerotherapy (CAES) demonstrates significant efficacy in treating outlet obstructive constipation (OOC) stemming from internal hemorrhoids (IH) and rectal mucosal prolapse (RMP).
• Successful OOC symptom management through CAES correlates with notable improvements in psychological well-being, specifically reducing anxiety and depression.