The clinical and therapeutic approach to anal stenosis


COD: 03_2018_08_2848 Categorie: ,

Marco Chiarelli, Angelo Guttadauro, Matteo Maternini, Giulia Lo Bianco,
Fulvio Tagliabue, Pietro Achilli, Sabrina Terragni, Francesco Gabrielli

Ann. Ital. Chir., 2018 89, 3: 237-241

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Anal stenosis is a fibrous narrowing of the anal channel. It develops, in most cases, in the aftermath of proctologic surgical
procedures with extensive anoderm excision or in the presence of chronic anal inflammation in patients with Crohn
Disease. However rare, this condition is thoroughly debilitating for the patients. Symptoms include constipation, pain
and bleeding with defecation and a reduction of the caliber of stools. Diagnosis is essentially clinical. Prevention of postsurgical
stenosis is based on a scrupulous surgical technique and on an extensive and carefully- planned follow up.
Treatment is based on an initially conservative approach with regularization of stool transit through hydration, dietary
fibers and bulk-forming laxatives. The role of mechanical dilatation in the treatment of AS is still debated. For severe
cases and cases that are not responsive to conservative treatment we must resort to surgery. Surgical approach is tailored
on the severity, position and extension. The most severe cases require anoplasty procedures with mucosal or anal flaps.