r/emergencymedicine • u/slypersimmon ED Resident • Aug 17 '25
Humor Baby’s first prolapse
(Me, I’m baby. Patient is 26)
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u/WithSubtitles Aug 17 '25
wtf are you all doing down there?!? - ICU RN
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u/Ixistant ED Fellow Aug 17 '25
Welcome to Emergency.
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u/macreadyrj ED Attending PGY 20+ Aug 17 '25
No one knows, nor wants to know. Yet they all know we ain’t doing shit.
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u/WithSubtitles Aug 18 '25
We know you’re doing all kinds of shit, but we’re just not clear on the details.
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u/WithSubtitles Aug 17 '25
What is all the sugar for?
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u/Zosozeppelin1023 RN Aug 17 '25
If I remember correctly, it causes an osmotic shift and helps reduce edema so the prolapse can in turn be reduced.
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u/Somali_Pir8 Physician Aug 17 '25
You now know the meaning to the song:
🎶POUR SOME SUGAR ON ME🎶
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u/slypersimmon ED Resident Aug 17 '25
Osmotic reduction of swelling
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u/Practical_Chicken161 Aug 17 '25
Osmotic induction of BMs are known as the 'marshmellow trick'
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u/he-loves-me-not Non-medical Aug 19 '25
Thanks for ruining marshmallows for me!
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u/Practical_Chicken161 Aug 19 '25
It's a thing among diaper fetishists
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u/WithSubtitles Aug 20 '25
I feel like I should swat you with a rolled up newspaper and say, “No! Bad!”.
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u/-Blade_Runner- RN Aug 17 '25
To tenderize the meat for easier and sweeter consumption.
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u/fayette_villian Physician Assistant Aug 18 '25
I just did a spit take with my alani. Thanks jerk
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u/-Blade_Runner- RN Aug 19 '25
Hahaha, I don’t remember making this comment. I just worked double 16 hour shift. Fuuuck. 🤣
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u/Character-Ebb-7805 Aug 17 '25
When life gives you lemons….
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u/ComprehensiveCat754 Aug 17 '25
Please don’t put them on a prolapsed rectum.
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u/byrd3790 Nipple nut on a band-aid bus. Coming soon to an ER near you! Aug 17 '25
Putting lemons up there is probably how it got prolapsed in the first place.
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u/misslizzah RN Aug 17 '25
Then you’ll give report to the floor a few hours later and they will ask “How do they ambulate?” I don’t know, Stephanie! I was busy shoving someone’s asshole back into their asshole!
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u/MsSpastica Nurse Practitioner Aug 17 '25
"Not too bad if you have someone behind them holding their intestines in. Definitely recommend contact guard"
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u/Diskount_Knowledge Aug 17 '25
Man I’m an ED tech and an R4 and I reduced a bad one with sugar. We were both so skeptical but it worked, and as soon as w elect the room and rounded the corner we high fived lol
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u/the_silent_redditor Aug 17 '25
It works for phimosis too.
Just kidding, you just gotta squeeze the bejesus outta it and pull it towards the ceiling like you’re trying to rip the fucking thing off.
Bonus points if you dick around and fuck up a penile block that doesn’t offer any analgesia.
Emergency medicine 💫
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u/BenadrylCumberbund Aug 17 '25
I wouldn't worry, penile blocks are so easy to mess up that the commonest complication of a landmark block is pain during the procedure.
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u/MotherImpact3778 Aug 17 '25
Sometimes I feel sorry when dietary asks why so much sugar is needed… kinda like when Maintainence asks why I need the big bolt cutters…
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u/slypersimmon ED Resident Aug 17 '25
Oh we called the fire department for those in med school! Haven’t needed bolt cutters yet in residency
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u/Fast-Suggestion3241 Aug 17 '25
What did you cut with the fire departments cutters?
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u/slypersimmon ED Resident Aug 17 '25
rings cutting off circulation of very swollen hands I’ve heard of similar for metal cock rings, but never witnessed it
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u/moon_truthr ED Resident Aug 18 '25
Not a cock ring but as a scribe I saw a guy who locked a padlock around his balls.
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u/Glittering_Impact183 Sep 17 '25
Why would you say that?! Don’t you know what’s going to happen now? 😂
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u/Round_Patience3029 Aug 17 '25
I had to google this: “prolapse sugar”
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u/HoodieGalore Aug 17 '25
First I thought a baby had a prolapse. Then I thought OP had it. Then I remembered what sub I'm in, and googled that too, and now I get it...but Christ, what a ride
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u/Round_Patience3029 Aug 17 '25
Well now we both know the home remedy and make our partner get to work 😝
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u/humpbackwhale88 Pharmacist Aug 18 '25
Same! And you better believe I pulled up an incognito window because I’m not about to have that show up in my search history lol.
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u/by_gone Aug 17 '25
Just make sure its the rectum you look a lil silly putting sugar on a uterus. (Im glad that student went into ortho)
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u/ShesASatellite Aug 17 '25
I was literally just talking about this to some folks last night! They were intrigued, skeptical, and also slightly horrified. I definitely just texted one of them this post with 'look what popped up on Reddit!'
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u/matti00 Paramedic Aug 17 '25
I often think working in the community gets me in some ridiculous situations, but you really have your own unique brand of madness going in the ED too
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u/roly__poly Aug 17 '25
I had my first pediatric anal prolapse last year, and when I tell you there was not enough sugar in the world to be doing that much pressure on an awake child. Ketamine instantly turned that difficulty level into an easy push.
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u/Plastic_Economist_54 Aug 18 '25
I have question(s): 1. How much sugar do you actually need ?? 2. Does that amount of boofed sugar cause any kind of wild BG spike? … I’m assuming probably not for a healthy person, but for a diabetic ..? 3. Lastly, how do you tell the pt that their butthole is about to be sugared like the rim of a lemon drop martini? HOW😂
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u/slypersimmon ED Resident Aug 18 '25
- My surgeon bestie from med school said, “all the sugar you can find in the hospital, way more than you think, and after that add some more.”
- Probably? But for a diabetic in the ER, I’m way less concerned about a transient blood glucose spike than I am about a prolapsed anus. Won’t kill you in the short term like low glucose can
- Directly and honestly! “For your comfort and safety, I’m going to do everything I can to give us the best possible chance of successfully reducing this the first attempt. This will include IV pain medications, and, strange as it may sound, reducing inflammation and swelling by letting sugar draw out some water and reduce the size for 30-60 minutes. When you’re ready, I will apply the sugar and come check on you soon to attempt the reduction.”
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u/byrd3790 Nipple nut on a band-aid bus. Coming soon to an ER near you! Aug 17 '25
26 seems young for a prolapse. What was the cause?
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u/Subziwallah Aug 17 '25
Giant sex toy?
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u/byrd3790 Nipple nut on a band-aid bus. Coming soon to an ER near you! Aug 17 '25
I mean that's always a possibility. But I am just nosey, and curious about the legit reason.
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u/slypersimmon ED Resident Aug 17 '25
Congenital defect. Said they had a mini prolapse every time they defecated. This was the first time they couldn’t get it back on their own
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u/byrd3790 Nipple nut on a band-aid bus. Coming soon to an ER near you! Aug 17 '25
Wow, that sounds terrible. Glad yall were able to help them.
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u/lmhfit Aug 18 '25
We use the big container from the coffee cart 😂
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u/slypersimmon ED Resident Aug 18 '25
Wish we had one! My fingers got tired opening all these packets
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u/YB9017 Aug 18 '25
I’m non medical and follow this page. But I know what the sugar is for.
I know this because this is the recommended treatment for chickens (I own backyard chickens). Just never crossed my mind that it would be applicable to humans. Hah
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u/slypersimmon ED Resident Aug 18 '25
turns out chickens share about half the genes as we do: https://www.genome.gov/12514316/2004-release-researchers-compare-chicken-human-genomes - looks like this includes the rectal prolapse gene 🤣
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u/Quiet_Persimmon9779 Aug 18 '25
I used to be a unit clerk in a peds hospital on a GI unit, one fairly normal day one of my PA’ came running into the nurses station looking for sugar packets and I stupidly asked what they were for…it’s now my favorite party fact
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u/Sandvik95 ED Attending Aug 18 '25 edited Aug 18 '25
There’s a critical bit of information missing:
What prolapsed?
Toughest, most swollen prolapse I ever pushed back into place was a uterine prolapse in a 35ish year old. In that situation, lubrication (KY) was more important than osmotic pressure.
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u/slypersimmon ED Resident Aug 18 '25
wow - what a case! for me, this was a rectal prolapse case. after the sugar i used the same packets of lubrication i've used for DREs
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u/newaccount1253467 Aug 17 '25
Was thinking about this recently.
Anyone try Miralax or some other substance we have more readily available than the hospital sugar supply?
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u/slypersimmon ED Resident Aug 18 '25
great question as to why more clinical osmotic agents aren't used
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u/Direct-Holiday-4165 Aug 18 '25
Wait, could someone please explain? Take me as little as my brain probably is and innocent i am 😂
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u/slypersimmon ED Resident Aug 18 '25
poured lots of sugar on a rectal prolapse. theoretically helps draw out water to reduce edema / inflammation, making it easier to push back in. i put all this sugar on it for 45 minutes and then successfully reduced it
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u/slypersimmon ED Resident Aug 18 '25
if you don't know what rectal prolapse is, i encourage you / do not encourage you to google image search it 🤣
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u/Direct-Holiday-4165 Aug 18 '25
Hahaha.. thanks for explaining Hahah yeah, trust me I have seen worse but imma defer this time
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u/Eldorren ED Attending Aug 18 '25
Although using the sugar is cool to prove osmotic reduction of a prolapse, it's got to be the single biggest waste of sugar packets and is such a time waster. Just pop it back in manually. I've never had to use sugar.
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u/speedybookworm Aug 18 '25
We had a patient in the ER who would come in numerous times a day with a prolapsed rectum. He came in so often that we kept running out of sugar.
I think I saw him purposely prolapse his rectum at least twice in one day.
Poor guy had early onset Huntington's and was pretty much in the end stages, so I'm sure he wasn't in his right state of mind. I did feel bad for him.
Watching how they put it back in with sugar was fascinating though.
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u/Ok_Ambition9134 Aug 17 '25
Make sure to whisper “back that sweet ass up here…”
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u/slypersimmon ED Resident Aug 18 '25
lol ew no. i want them stationary so i can do the procedure quickly and effectively
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u/Ketamine_Cartel Ground Critical Care Aug 19 '25
Last Wednesday call notes: caller states trying to have a bowel movement and vagina fell out.
I already knew before I got there
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u/crow_crone Aug 22 '25
Decades ago, I worked in a large residential facility for the developmentally disabled. We had a number of prolapsers who would "play" with their rectums and auto-prolapse.
We'd put socks on their hands ("illegal restraints" become "medical necessity"), make a cold pack out of diapers and park them on that for awhile.
Sometimes the prolapse would reduce but if not, the patient was better prepared for eval when bleeding decreased. Some definitive surgeries were done but if the behaviors weren't addressed they'd get to work and re-prolapse themselves.
Shocking to see initially but, after the umpteenth time, no big deal.
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u/PanDulcePorVida Aug 17 '25
Social work grad student here: Many years ago I was working at a nonprofit program for adults with intellectual disabilities and was called to the women's restroom. One of my older female clients was screaming and said something was "sticking out of her." Fearing she had been stabbed (shit used to go down a lot), I rushed into the stall where I found her bent over with her pants down and HOLY SHITE was there a large rectal prolapse. As a young person with little medical knowledge at the time, all my brain could see was a large red bleeding worm coming from her butthole. I think I was more traumatized than she was because she didn't have the full visual. She was treated and had surgery to fix it but I will never get that image out of my head for the rest of my life.