Anal stenosis is the name given to the unpleasant but relatively uncommon condition in which the anal canal tightens and narrows, leading to difficulty in passing a bowel movement. Also referred to as rectal stricture or anal stricture. The muscles of the anus do not expand and contract normally during defecation, which (in addition to the incomplete expulsion of stool) can cause constipation, straining, bleeding and pain.
If not treated early enough, serious long-term complications can occur. This article focuses on the treatment of anal stricture. We recently wrote an article explaining in detail the causes, symptoms and diagnosis of anal stricture, so it will recap key questions and outline possible treatment options for anal stricture.
What are the causes and symptoms of anal stricture?
Stenosis usually affects the internal sphincter, which is the involuntary sphincter located inside the external sphincter. The external clamp is under your control so you can decide when it’s convenient to have a bowel movement.
In most cases, the cause of anal stricture is the formation of scar tissue resulting from a surgical procedure in the anal area, such as removing hemorrhoids or a skin tag. Anal stricture is always caused by scar tissue, but this scar tissue can have various causes.
Other reasons for scar tissue to form in and around the anus include:
- Congenital malformation
- Sexually transmitted disease
- Rectal infection
Symptoms of anal stricture may include:
- Constipation
- Straining (leading to anal fissures and tears, which in turn can cause spasms)
- Painful bowel movements
- Small or thin stools that may come out in pellets
- Fresh blood (which has a bright red color)
Symptoms of rectal stricture may initially be tolerable, but may worsen over time if left untreated. It is important to get treatment for anal stricture as early as possible to avoid more serious problems later.
Do I have anal stricture?
It is important not to mistake anal fissures (small, painful tears in the lining of the anus) for anal strictures. Constipation is not necessarily a sign of stenosis, although it is also a symptom. If you consistently experience both, however, anal stricture may be the cause. Bleeding from the anus can also have various causes, but should always be a reason to seek a medical examination.
Diagnosing anal stricture is relatively simple. A qualified physician will perform a physical examination and evaluate your symptoms and medical history to reach a conclusion. If necessary, at this point you will be able to receive treatment for anal stricture. You can also do rectal stricture treatments at home if you prefer.
How do you treat anal stricture?
There are both surgical anal stricture treatments and non-surgical anal stricture treatments. Studies show that anal stricture treatments are usually effective, but what you need will depend on the severity of your condition.
Below are the most common methods of treating anal stricture:
Dietary Adjustments
If you have a mild rectal stricture, you should consider including more fiber in your diet. This makes the stool larger but softer, so it will be easier to pass. Very bulky or large stools can cause pain when you try to pass them, so it’s important to soften them enough to pass easily.
Stool softeners and laxatives
If the stricture is rated as mild or moderate, you may be able to use stool softeners or laxatives that soften your stool. However, as these can dehydrate the gut, they are not recommended for long-term use and may be best used when symptoms are particularly severe.
Steroid or Botox injections
Your doctor may recommend steroid injections into the scar tissue, which are known to reduce the recurrence of the stricture. Alternatively, they may wish to use Botox injections to reduce the appearance of spasms, which worsen the stenosis.
Surgery
Surgery for anal stricture consists of the following options:
- Sphincterotomy/lateral internal sphincterotomy: cutting the internal sphincter muscle to release tension or repair anal fissures and prevent spasms
- Anoplasty: surgical reconstruction of the anus to replace defective tissue with a flap of healthy tissue, after removal of scar tissue (usually for severe stricture)
Under local anesthesia, your doctor can incise the ring of scar tissue through the skin of the anus to allow the anal canal to expand normally. After this point, rectal dilators are usually recommended to help with continued stretching during the healing process.
Anal dilatation
Anal dilation is a simple and effective way to gently stretch the anal canal. It can be done with a finger or fingers, but this can be somewhat uncomfortable. It is also less hygienic than using an anal dilator, which is recommended by professionals in the treatment of anal strictures. Rectal dilatation twice a day for two months may help restore normal rectal capacity, but the necessary frequency should be confirmed by your healthcare provider.
Magnetic rectal dilators are particularly useful for releasing tight rectal muscles and gently expanding the rectum. They are the best rectal dilator after anal surgery and can help relax and soothe painful rectal muscles. The rectum should be dilated in order to avoid the scarring and stricture associated with anal stricture. Neodymium magnets increase blood flow to the anus, speeding healing and soothing the nerves.
Neodymium magnetic therapy is a great health benefit because the magnetic fields have the ability to stimulate healing as they pass through cells and tissues. Neodymium magnets in particular are the strongest neomagnets, meaning they can penetrate deeper than other magnets.
How to use rectal dilators
- Wash your anal dilator before use with warm water and a mild hypoallergenic soap
- Get into the most comfortable position you can (many people prefer to lie on their left side)
- Use a water-based lubricant to cover the tip of the dilator and the anus entrance to avoid any tearing or discomfort (petroleum-based lubricants increase the risk of infection as they do not rinse well)
- Gently place the tip of the dilator at a right angle to the entrance of the anus
- Breathe deeply and ease the dilator into the anal passage
- When only the flat end of the anal dilator is in contact with the skin, it is fully inserted. Do not enter further in case recovery is difficult
- Leave the dilator in for the length of time recommended by your doctor according to the severity of your anal stricture
- Wash and dry your dilator thoroughly with hypoallergenic soap and water after use
Keep in mind that hygiene is of the utmost importance, as this area is home to many different types of bacteria. Always ensure that it is thoroughly cleaned after each use. If you find that you are uncomfortable or feel too tense, stop the rectal dilator treatment until you feel more relaxed. It will get easier with practice, but it’s best not to rush it. It takes time and patience to recover from anal stricture.
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