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Definition
Anal stenosis means that the anus is narrow and it is difficult to pass even soft stool, so the stool is always thin and there is a feeling of not having a bowel movement even after having a bowel movement.
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Causes
  • 01

    In general, the cause of anal stenosis occurs as a sequelae of excessive resection of the anus during hemorrhoidectomy.
  • 02

    Anal stenosis can also be aroused when non-doctors inject a cauterant to their patients. Escharotics, not hardeners, may cause changes similar to burns in the anus, causing hemorrhoids to erode. At this time, scars are formed in the anus, shrinking and narrowing the anus, and cause stenosis.
  • 03

    Other causes of anal stenosis include recurrent anal fissures, chronic diarrhea, recurrent anal abscesses and fistulas, anal Crohn's disease, side effects of radiation therapy, and resection of perianal skin lesions for Paget's disease or Bowen's disease.
Diagnosis of Anal Stenosis?
If you experience the symptoms listed above, such as narrow and inflexible anus, ripped and bleeding anus when you have a bowel movement, thin stools, and a feeling of remaining feces after a bowel movement, you can diagnose yourself as an anal stenosis. If you go to a specialized hospital to determine exactly, a doctor will examine the size and elasticity of your anus with the second finger of his/her right hand (anus examination). And it can be quantitatively measured through anal manometry, which measures the internal pressure of the anus.
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Treatments
Treatment of anal stenosis depends on where the stenosis is located in the anus and how severe it is. Higher types of anal strictures that are located deep in the anus are more difficult to treat than lower anal strictures located near the anus. Mild stenosis can be treated without surgery, but severe anal stenosis may require extensive surgery.
Nonsurgical Treatments
  • · Fiber Intake:

    Eat a lot of vegetables or fruits to expand and soften the stool so that it does not injure the stricture area of the anus, and the stricture area becomes gradually flexible as the stool passes.
  • · Expansive laxatives:

    If the fiber intake alone can not solve the problem, you should take an expansive laxative, such as chamomile powder, to further enlarge the stool and soften the anal stricture. Expansive laxatives have few side effects, so it is safe to take them for a long period of time.
  • · Self Anal Massage with Fingers:

    In case of more severe anal stenosis, try to expand your anus sphincters repeatedly using a finger or a dilator.
Surgical Treatments
  • · Lateral Internal Sphincterotomy

        This is a procedure that widens the anus by exciding part of the internal sphincters.
  • · Sliding Skin Graft Method

        After making an incision at the stenosis site, the mucous membrane is moved into the anus and sutured. It is a procedure that is not often used, however.
  • · V-Y Advancement Flap

        This is a surgical method used to treat anal stenosis and eccentricity of the anal mucosa, that is, the protrusion of the anal mucosa outside the anus. This is to first make a V-shaped incision in the lesion, pull the skin into the anus, and then suture it in a Y-shape. This will make the anus as wide as the V-shaped skin and allow the anal mucosa to re-enter.
  • · Y-V Advancement Flap

        This is also a surgical procedure used for anal stenosis and protrusion of the mucous membrane, but it is slightly different from the V-Y procedure. It is a method of making a Y-shaped incision at the stenosis of the anus, and then pulling the V part of the Y-shape into the anus and suture it.
  • · House Advancement Flap

        After making a house-shaped incision, a doctor will pull the bottom of the house to the inside of the anus and suture it, so that the anus becomes as wide as the house-shape.

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