Prolapse of the rectum

Also anal desertion. The downward fall of the rectum through the anus. Prolapse of the rectum is most prevalent among the young and the aged and is the result of center qì fall, a qì vacuity pattern, or of damp-heat in the large intestine.

Patterns

Center qì fall (中气下陷 zhōng qì xià xiàn): Prolapse of the rectum due to center qì fall occurs when coughing or defecating. The patient has to press the rectum back into place with the hand. The prolapsed part is pale without redness, swelling, or pain. The facial complexion is white and the lips are pale. There is shortness of breath and in some cases cough. The tongue is pale with scant fur, and the pulse is a forceless weak and vacuous.

Medicinal therapy: Treat by boosting qì and raising the fall with Center-Supplementing Qì-Boosting Decoction (补中益气汤 bǔ zhōng yì qì tāng).

Acumoxatherapy: Base treatment mainly on back transport points, GV, and BL. Select GV-20 (Hundred Convergences, 百会 bǎi huì), BL-25 (Large Intestine Transport, 大肠俞 dà cháng shù), GV-1 (Long Strong, 长强 cháng qiáng), and BL-57 (Mountain Support, 承山 chéng shān); needle with supplementation and add moxa.

Point selection according to cause: When prolapse of the anus results from enduring diarrhea or dysentery, add ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), and CV-6 (Sea of Qì, 气海 qì hǎi). When due to excessive childbirth in women, add BL-23 (Kidney Transport, 肾俞 shèn shù), CV-6 (Sea of Qì, 气海 qì hǎi), and SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo).

Kidney yáng vacuity (肾阳虚 shèn yáng xū): Prolapse of the rectum with clouded head, flowery vision, forgetfulness, fifth-watch sloppy diarrhea, and in some cases seminal emission and impotence is due to kidney yáng vacuity. Other signs include limp aching lumbus and knees, generalized fear of cold, and frequent urination. The tongue is enlarged and tender-soft; the pulse is sunken and fine.

Medicinal therapy: Combine boosting qì, lifting, and securing with powerful warming and supplementing of kidney yáng. Use Cinnamon Bark and Aconite Eight-Ingredient Pill (桂附八味丸 guì fù bā wèi wán) plus codonopsis (Codonopsis Radix, 党参 dǎng shēn), astragalus (Astragali Radix, 黄芪 huáng qí), cimicifuga (Cimicifugae Rhizoma, 升麻 shēng má), bupleurum (Bupleuri Radix, 柴胡 chái hú), chebule (Chebulae Fructus, 诃子 hē zǐ), and sumac gallnut (Galla Chinensis, 五倍子 wǔ bèi zǐ).

Acumoxatherapy: Base treatment mainly on GV, CV, and back transport points. Select GV-20 (Hundred Convergences, 百会 bǎi huì), BL-25 (Large Intestine Transport, 大肠俞 dà cháng shù), GV-1 (Long Strong, 长强 cháng qiáng), BL-57 (Mountain Support, 承山 chéng shān), BL-23 (Kidney Transport, 肾俞 shèn shù), GV-4 (Life Gate, 命门 mìng mén), CV-4 (Pass Head, 关元 guān yuán), and KI-3 (Great Ravine, 太溪 tài xī); needle with drainage.

Damp-heat (湿热 shī rè): Prolapse of the rectum due to damp-heat brewing and amassing is characterized by redness, swelling and pain of the prolapsed part. There may be thirst and dry stool. The facial complexion and lips are red. The tongue body is red with a yellow fur. The pulse is stringlike and rapid.

Medicinal therapy: Treat by clearing heat and disinhibiting dampness assisted by raising the fall using Four Agents Decoction (四物汤 sì wù tāng) plus scutellaria (Scutellariae Radix, 黄芩 huáng qín), coptis (Coptidis Rhizoma, 黄连 huáng lián), sophora flower (Sophorae Flos, 槐花 huái huā), cimicifuga (Cimicifugae Rhizoma, 升麻 shēng má), and bupleurum (Bupleuri Radix, 柴胡 chái hú). Sumac gallnut (Galla Chinensis, 五倍子 wǔ bèi zǐ) and alum (Alumen, 白矾 bái fán) can be decocted to make a wash. Pay attention to physical exercise to improve the constitution.

Acumoxatherapy: Base treatment mainly on back transport points, GV, BL, SP, and LI. Needle with even supplementation and drainage at GV-20 (Hundred Convergences, 百会 bǎi huì), BL-25 (Large Intestine Transport, 大肠俞 dà cháng shù), GV-1 (Long Strong, 长强 cháng qiáng), and BL-57 (Mountain Support, 承山 chéng shān), and with drainage at LI-4 (Union Valley, 合谷 hé gǔ), LI-11 (Pool at the Bend, 曲池 qū chí), and SP-9 (Yīn Mound Spring, 阴陵泉 yīn líng quán).

Etymology

Chin The Chinese term literally means shedding or desertion of the anus, hence anal desertion has been included as a synonym.