Patients with anal strictures will present with constipation and pain with defecation. They may also have abdominal distention, rectal bleeding, watery rectal discharge from the passage of loose contents around a fecal impaction, and tenesmus.
Treatment of anal stricture is ultimately surgical for complete resolution, except in instances where the stricture is due to inflammation (eg, inflammatory bowel disease) without irreversible fibrosis. In these cases, treatment of the underlying cause may be beneficial. However, since the risks of anoplasty with partial sphincterotomy are considerable, often more supportive measures such as stool softeners, a high-fiber diet, or anal dilatation is attempted as first-line therapy.
K62.4 – Stenosis of anus and rectum
55960007 – Stricture of anal canal
Differential Diagnosis & Pitfalls
- Hirschsprung disease – congenital; suspect with no passage of meconium within 48 hours of life.
- Meconium ileus – highest incidence in cystic fibrosis.
- Small left colon syndrome