Anal stenosis is narrowing of the anus, making it difficult to pass stool. It can be congenital or acquired, and there are treatment options available. Conservative treatments are usually tried first to see if they are sufficient for handling a case, before proceeding to more aggressive options for management of anal stenosis. Patients can work with a general practitioner or a proctologist in the development of a treatment plan.
Some people are born with strictures in the anus, leading to a narrowed anus or difficulty relaxing enough to defecate. This is different from imperforate anus, a rare birth defect where no anal opening is present. Other people get anal stenosis later in life, usually as a complication of aggressive hemorrhoid surgery. The patient will have difficulty defecating and may experience discomfort and a feeling of fullness caused by retaining feces. Over the long term, people are at risk of complications along the length of the bowel and it is important to address anal stenosis before these complications develop.
One option for management of anal stenosis is diet. Eating more fiber and adapting the diet slightly can keep the stool soft enough to pass easily, even through a narrowed anus. Some patients may be given laxatives. Manual dilation of the anus, where a finger is used to free impacted stool, is also an option. If these treatments are not sufficient, surgery to open the anus and resolve the problem may be the best option.
In an anoplasty surgery, a doctor will build a new anus for the patient, with an opening wide enough for the patient to defecate comfortably. After surgery, patients may experience some problems with incontinence during recovery and it is important to follow dietary and other medical recommendations to increase the chances of healing smoothly, with minimal complications. Patients who need surgery to treat anal stenosis should also watch closely for the development of hemorrhoids if they've had a problem with them in the past.
Patients may be embarrassed about seeking medical treatment when it comes to management of conditions involving the anus, but prompt medical care can help prevent complications and may provide patients with more treatment options. Doctors have seen a variety of things over the course of their careers and addressing problems with bowel movements is all part of the job. Patients who feel uncomfortable with a given care provider can request a referral to a different doctor.