How Do We Define Enterocele?
Enterocele also known by the name of Small Bowel Prolapse is known to occur when the small bowel descends into lower pelvic cavity and starts pushing on the top portion of the vagina thus forming a bulge in that area. The main cause of Enterocele is childbirth along with natural aging process and processes which put pressure on the pelvic floor thus weakening the muscles and ligaments supporting the organs in the pelvis thus predisposing the individual to have Enterocele. Enterocele is best managed by conservative means and through self care techniques. A surgical procedure may be required in acute cases of Enterocele.
What Are The Causes Of Enterocele?
The main cause for Enterocele is the increase in the pressure on the pelvic floor. This pressure can be increased due to various reasons and include:
- Chronic constipation
- Straining during bowel movements
- Chronic cough
- Repeated heavy lifting
Who Is At Risk For Getting Enterocele?
Some of the risk factors which increase the risk of an individual to get Enterocele are as mentioned below:
- Childbirth: If a female delivers vaginally then it tends to weaken the pelvic floor and its associated structures thus increasing the risk for developing an Enterocele. More the number of children delivered vaginally, more is the risk of developing Enterocele. Delivery through C-section decreases the risk somewhat.
- Age: Age also plays an important factor is development of Enterocele since as an individual ages the muscle mass of that individual becomes less and weakness in the muscles sets in thus increasing the risk for Enterocele.
- Surgery to the Pelvis: Surgical procedures like hysterectomy or other surgeries performed in or around the pelvic area weaken the pelvic muscles thus increasing the risk for Enterocele.
- Increased Pressure on the Abdomen: Obesity also plays an important role in the development of Enterocele. Individuals who are overweight put extra pressure on the muscles of the abdomen and thus increase the risk of developing Enterocele. Additionally, chronic and repeated bouts of coughing especially in smokers, and chronic constipation in which an individual has to strain excessively during bowel movements puts extra pressure on the abdomen thus increasing the risk for Enterocele.
- Smoking: Smokers are at an increased risk for developing Enterocele. This is because smoking irritates the lungs resulting in chronic coughing which in turn puts extra pressure on the abdominal muscles thus increasing the risk for an Enterocele.
- Race: For reasons which are absolutely unclear it is shown in studies that Hispanics and Caucasians tend to develop Enterocele more than others. The study shows that African-American females are at the least risk.
- Family History: If an individual has a family history of Enterocele, then that individual is at an increased risk for developing Enterocele.
- Connective Tissue Diseases: If an individual has any disorder of the connective tissues then that individual is at an increased risk for developing Enterocele.
What Are The Symptoms Of Enterocele?
Some of the symptoms of Enterocele are:
- A pulling sensation in the pelvis which calms down with lying
- A sensation of fullness in the pelvis with associated pain
- Low back pain
- A small bulge in the top part of vagina
How Is Enterocele Diagnosed?
In order to confirm the diagnosis of Enterocele, the treating physician will perform a detailed pelvic examination. The physician will also ask the individual to perform a Valsalva maneuver which will cause the small bowel to move downwards thus confirming the diagnosis.
What Are Treatments For Enterocele?
Treatment is not required for extremely mild cases of Enterocele where as surgical procedure may be required for acute cases which become quite bothersome to the individual. Some of the treatment options for Enterocele are:
Observation: If the condition is pretty much asymptomatic then the physician will decide to observe the condition and offer no particular treatment. Simple exercises like Kegel's exercises are recommended in such cases to strengthen the pelvic muscles. The physician will recommend not performing any sort of heavy lifting till the condition resolves.
Pessary: This is a silicone rubber device which is inserted into the vagina which supports the bulging tissue. The physician will instruct in how to remove, insert and clean the device.
Surgery: As stated, surgical procedure may be required in acute cases of Enterocele. This is done by repairing the prolapse through the abdomen or the vagina. In this procedure, the surgeon will put the small bowel back into its normal position and will tighten the connective tissues so that it does not move out of position again.
Home Remedies Or Selfcare Techniques For Enterocele
Some of the home remedies or self care techniques suggested for Enterocele are:
- Kegels exercise can be very helpful to strengthen the pelvic muscles and provide support to the weak vaginal tissues.
- Important to stay hydrated and to avoid getting constipated. Drink plenty of fluids and eat high-fiber foods, fruits and vegetables so as to avoid constipation.
- Try and not perform heavy lifting as that can put a lot of pressure on the pelvic muscles.
- Control frequent coughing as coughing can weaken the abdominal and pelvic muscles.
- Important to maintain ideal weight.
- Avoid straining during bowel movements.
What Are The Ways To Prevent Enterocele?
Some of the preventive measures that can be taken to prevent Enterocele are:
- Maintaining a Healthy Lifestyle and Monitoring Weight: In case if an individual is obese, then losing weight in a healthy way is extremely helpful since it decreases the pressure put on the abdominal muscles and thus decreases the risk for developing Enterocele.
- Diet: it is important to eat foods which is high in fiber as it prevents constipation and consuming plenty of fluids as constipation leads to straining during bowel movements and thus increases the pressure on the abdominal muscles
- Chronic Coughing: Persistent coughing, especially in smokers, need to be treated to decrease pressure on the abdominal muscles. Therefore, quitting smoking is imperative to cut down the risk for developing Enterocele.
- Heavy Lifting: It is advisable to avoid lifting heavy items as they tend to increase pressure on the abdominal muscles increasing the risk for developing Enterocele.