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

Abstract

Background and study aimsOutlet obstructive constipation (OOC) is a common type of chronic constipation that is usually caused by internal hemorrhoids (IH) and rectal mucosal prolapse (RMP). Cap-assisted endoscopic sclerotherapy (CAES) was demonstrated to be effective in the treatment of IH and RMP. This study explored the efficacy of CAES in treating OOC associated with IH and RMP. MethodsThirty-one patients (15 males and 16 females) were diagnosed with OOC after colonoscopy and anorectal manometry (AM). CAES was used to treat IH and RMP. The self-rating anxiety scale (SAS), self-rating depression scale (SDS), and Wexner constipation score (WCS) were used to assess patients at baseline and at the end of follow-up. AM tests were performed before and after CAES. ResultsThe mean age of patients was 56.19 ± 7.969 years, and the follow-up time was 2.875 ± 3.703 months. After CAES treatment, subjective indices, including frequency of bowel movements (p < 0.05), defecation time (p < 0.05), SAS (p < 0.05), SDS (p < 0.05), and WCS (p < 0.05), were significantly improved. AM showed that the anal relaxation rate (p < 0.05), maximum squeeze pressure (p < 0.05), and rectal residual pressure (p < 0.05) were significantly improved. The ratio of Bristol stool form scale typeIII–Vincreased from 12.5 % to 56.25 % (p < 0.05). ConclusionsCAES is effective for treating OOC caused by IH and RMP. The relief of OOC symptoms could improve anxiety and depression symptoms associated with the disease.