- When a healthy person increases the intra-abdominal pressure and relaxes the pelvic floor muscles, there will not be any changes in the concavity of the perineum.
- In chronic ill-patients, malnourished, and people with preprolapse, perineal descent can occur with obliteration of the normal concavity of the perineum. It is called as descending perineal syndrome.
- Levators got injured directly or indirectly causing weakening of pelvic floor.
- Anal canal is situated many centimeters below the pubo coccygeal line. Usually 3–4 cm low during straining.
- Defecography is ideal to evaluate such patients. Perineometer is also used.
Presentations are tenesmus; incomplete evacuation; incontinence.
- Treatment is diet, laxatives, avoiding straining, and suppositories.
- Restoration of pelvic floor by various surgical methods may be needed often with rectal resection and suspension.
- Total pelvic marlex mesh repair; transcoccygeal posterior hitching of the rectum (Kraske); correction of cystocele, rectocele and enterocele.
- Results are not very good as recurrence or residual problems may persist.
HOMEOPATHIC MANAGEMENT: -
Here Homeopathic medicine can act effectively in combating the symptoms related to the disease conditions. Homeopathic mode of treatment is based on the axiom of similia similibus curentur, and hence Homeopathic mode of treatment is the best mode of treatment for combating any illness.