Anal stricture
Anal stricture refers to the narrowing of the anus, which can lead to difficulty in passing stool, among other symptoms. This condition can be caused by various factors, including inflammation, injury, or previous surgeries. Anal strictures can significantly impact an individual's quality of life, necessitating appropriate diagnosis and management.
Causes
Anal strictures can result from several causes, including:
- Chronic inflammatory diseases such as Crohn's disease or ulcerative colitis
- Trauma or injury to the anal region
- Infections that lead to scarring
- Surgical procedures around the anus, including those for hemorrhoids or anal fissures
- Radiation therapy for cancer treatment near the anal area
Symptoms
Symptoms of anal stricture may include:
- Difficulty in passing stool, leading to constipation
- Pain during bowel movements
- Narrowing of the stool caliber
- Rectal bleeding or blood on the toilet paper
- A feeling of incomplete evacuation after a bowel movement
Diagnosis
Diagnosis of anal stricture typically involves a combination of:
- Medical history review and physical examination, including a digital rectal exam
- Anoscopy or proctoscopy to visually inspect the anal canal
- Imaging studies, such as an MRI or ultrasound, to assess the structure of the anal canal and surrounding tissues
Treatment
Treatment options for anal stricture depend on the severity of the condition and the underlying cause. They may include:
- Anal dilation: Gradual stretching of the anal canal
- Medications: To treat underlying conditions such as inflammation or infection
- Surgery: Procedures like an anoplasty to widen the anal canal or remove scar tissue
Prevention
Preventing anal strictures involves managing underlying conditions that could lead to the development of strictures, avoiding anal trauma, and seeking prompt treatment for anal injuries or infections.
Complications
If left untreated, anal strictures can lead to complications such as:
- Severe constipation
- Fecal impaction
- Increased risk of anal tears or fissures due to straining
- Infection due to retained fecal matter
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Contributors: Prab R. Tumpati, MD