OBSESSIVE COMPULSIVE DISORDER AND RECTAL PROLAPSE

Abstract

BackgroundObsessive Compulsive Disorder (OCD) is a common Psychiatric illness affecting up to 3% of adults and children. It is a chronic and disabling illness that impacts negatively on the academic, occupational, social and family function of patients.Rectal prolapse is a condition in which the rectum becomes stretched out and protrude out of the anus. A majority of patients with rectal prolapse are completely relieved of symptoms or are significantly helped by surgical procedure. It is however essential, that chronic constipation and straining post surgical correction should be avoided in order to prevent recurrences.Research has suggested that individuals with OCD experience more physical symptoms, however, few studies have looked at the physical complication of rectal prolapse in individuals with OCD. There has been a case report of a patient with OCD and rectal prolapse who had an obsession with bowel emptying due to fear of developing cancer [1] MethodWe carried out a retrospective analysis of 774 cases of OCD patients recorded from 2011 to 2014 to identify those with rectal prolapse. A case review was then performed on those identified. ResultsThree cases of rectal prolapse were noted from the 774 cases. Overall this represented:1 patient with OCD and rectal prolapse presumed to be caused by excessive straining.1 patient with Schizophrenia, OCD symptoms and rectal prolapse again presumed to be a consequence of extreme straining.1 patient with OCD and despite patient’s conviction of a prolapse, none seen. ConclusionsRectal prolapse is a rare but severe possible complication of OCD. We would like to promote a greater awareness among medical professionals of this complication and the need to examine patients suspected of rectal prolapse. Research has suggested that individuals with OCD experience more physical symptoms, however, few studies have looked at the physical complication of rectal prolapse in individuals with OCD.