Anal stenosis is the name for the uncomfortable but relatively uncommon condition in which the anal canal tightens and narrows, leading to difficulty in passing stools. It is also referred to as rectal stenosis or anal stricture. The anal muscles do not expand and contract normally during defecation, which (aside from incomplete passing of stools) can cause constipation, straining, bleeding and pain.
If not treated early enough, serious long-term complications can result. This article focuses on treating anal stenosis. We recently wrote an article explaining anal stenosis causes, symptoms and diagnosis in detail, so this will recap on basic questions and outline the possible treatment options for anal stenosis.
What are anal stenosis causes and symptoms?
Stricture usually affects the internal sphincter, which is the involuntary sphincter located inside the external sphincter. The external sphincter is under your control, so that you can decide when it is convenient to pass stools.
In most instances, the cause of anal stenosis is the scar tissue formation resulting from a surgery in the anal area, such as hemorrhoid or skin tag removal. Anal stenosis is always caused by scar tissue, but this scar tissue can have various causes.
Other reasons for the formation of scar tissue in and around the anus include:
- Congenital malformation
- Sexually transmitted disease
- Rectal infection
Anal stenosis symptoms 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 is bright red in color)
Symptoms of rectal stenosis may initially be tolerable, but can get worse over time if they are not treated. It is crucial to get treatment for anal stenosis as early as possible so as to avoid more serious problems later.
Do I have anal stenosis?
It is important not to mistake anal fissures (small, painful tears in the rectal lining) for anal stenosis. Constipation is not necessarily an indicator of stenosis either, although it too is a symptom. If you consistently experience both, however, anal stricture may be the cause. Bleeding from the anus may also have various causes, but should always be a reason to seek medical examination.
It is relatively simple to diagnose anal stenosis. A qualified medical practitioner will do a physical examination and assess your symptoms and medical history to come to a conclusion. If necessary, at this point you will be able to get treatment for anal stenosis. You can also do anal stenosis treatments at home if you prefer.
How do you treat anal stenosis?
There are both surgical anal stenosis treatments and non-surgical anal stenosis treatments. Studies show that anal stenosis treatments are usually effective, but what you need will depend on the severity of your condition.
Below are the most common anal stenosis treatment methods:
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Dietary Adjustments
If you have mild rectal stenosis, you will need to consider including more fiber in your diet. This makes stools larger but softer, so it will be easier to pass them. Very bulky or large stools can cause pain when attempting to pass them, so it is important to soften them enough that they can pass easily.
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Stool softeners and emollient laxatives
If stricture is assessed as mild or moderate, you may be able to use stool softeners or laxatives that soften your stools. However, since these can dehydrate the bowel, they are not recommended for long-term use and may be best used when symptoms are particularly challenging.
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Steroid or Botox injections
Your healthcare practitioner may recommend steroid injections into the scar tissue, which is known to lessen the recurrence of stricture. Alternatively they may wish to use Botox injections to reduce the occurrence of spasms, which worsen stricture.
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Surgery
Surgery for anal stenosis 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 in order to replace defective tissue with a flap of healthy tissue, after scar tissue removal (usually for severe stenosis)
Under local anesthetic, your Doctor may incise the ring of scar tissue through the anal skin to allow normal expansion of the anal canal. After this point, anal dilators are usually recommended to assist in continued stretching during the healing process.
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Anal dilation
Anal dilating 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 awkward. It is also less hygienic than using an anal dilator, which is recommended by professionals in the treatment of anal stenosis. Dilating the anal canal twice a day over the course of two months can help to restore normal anal capacity, but the necessary frequency will need to be confirmed by your healthcare provider.
Magnetic rectal dilators are particularly helpful for releasing tight anal muscles and gently expanding the rectum. They are the best rectal dilator after anal surgery and can help to relax and soothe painful rectal muscles. The rectum should be dilated in order to prevent the scarring and narrowing associated with anal stenosis. Neodymium magnets increase blood flow to the anus, quickening healing and soothing nerves.
Neodymium magnetic therapy is a great benefit to health because magnetic fields have the ability to stimulate healing as they pass through cells and tissues. Neodymium magnets in particular are the strongest neomagnets, meaning that 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 prefer laying on the left side)
- Use a water-based lubricant to cover the tip of the dilator and the entrance to the anus, so as to avoid any tearing or discomfort (petroleum-based lubricants increase infection risk as they don’t wash off well)
- Gently position the tip of the dilator at a right angle to anal entrance
- 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 insert any further in case retrieval is difficult
- Leave the dilator in for the period of time your practitioner has recommended in accordance with the severity of your anal stenosis
- Wash and dry your dilator thoroughly with hypoallergenic soap and water after use
Please note that hygiene is of the utmost importance, since this area is home to many different types of bacteria. Always make sure it is fully cleaned after each use. If you find that you are becoming uncomfortable or experiencing excessive tension, stop the anal dilator therapy until a time when you feel more relaxed. It will get easier with practice, but it is best not to rush. It takes time and patience to recover from anal stenosis.
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Resources
Pubmed.ncbi.nlm.nih.gov/17610693/
