Amid reports of 16-inch bottle gourd stuck in 60-year-old’s rectum, doctor says ‘first such case in medical literature was reported in the 16th Century’

What you need to know about foreign objects lodged in the rectum

Foreign bodies in the rectum are not a new phenomenon; the first case in medical literature was reported in the 16th century, said consultant neurologist Dr Sudhir Kumar, Apollo Hospitals, Hyderabad. “The causes can range from sexual activity gone wrong, sexual assault, accident, or by intention like heroin or drugs, or even mental health issue,” Dr Kumar added.

According to a 2022-International Journal of Science and Research (IJSR) report, anorectal foreign objects are rare cases in emergency services, and that first described the report on the management of retained rectal foreign bodies dates back to the 16th century. “They mostly appear to involve 30-40-year-old patients, with two-thirds being males. The management of this intriguing problem has evolved with the edition of laparoscopic, endoscopic, and minimally invasive surgical options,” the report read.

The report mentioned anorectal foreign objects are generally things made from plastic, aluminium or glass bottles, eggplant, carrot or wood of different sizes.

Large objects can block the passage of stool as well as gas leading to emergency surgeries, said Dr Mahesh Chikkachannappa, senior consultant, general, gastrointestinal, laser proctology, laparoscopic and bariatric surgery, Aster CMI Hospital, Bengaluru. “Objects can cause lacerations and bleeding within the rectum,” he said.

In most cases, it causes pain in the anus or rectum, constipation or incontinence. “Sometimes, it can perpetrate the rectal wall, which can be a serious issue. It can cause peritonitis where the infection spreads into the abdomen and its covering. From there, the infection can spread to the rest of the body — called sepsis — which is a serious condition,” explained Dr Kumar.

Here’s what to understand (Source: Freepik)

According to a 2022-National Center for Biotechnology Information report, choosing the most appropriate method of extraction is often difficult. “About 35-40% of those with associated injuries and complications necessitate urgent surgical removal,” it read.

If the object is found in the rectum without an accompanying infection, the object can be removed “easily” by the trans-anal route. “Sometimes, if there are signs of infection, the trans-anal route may not be used. It needs surgery like laparotomy or laparoscopy,” said Dr Kumar.

Dr Chikkachannappa said that it is advisable not to attempt to remove the object yourself, as this can worsen the situation.

Dr Kumar also emphasised that many times, “people delay treatment due to embarrassment”.

“However, in an emergency, immediate hospitalisation and removal of the object are needed. In some cases, antibiotics may also be needed. It can be treated well in time. Otherwise, it can be fatal too in a few minority cases,” said Dr Kumar.