Anorectal malformations occur when your baby is born with an anus or rectum that didn’t develop properly. These malformations can make it difficult or even impossible for your baby to pass stool. Treatment usually includes surgery to correct the malformation when your baby is a few days old.
An anorectal malformation is a condition in which the rectum and anus of the developing fetus don’t form properly before birth. The anus and rectum are the lower portions of the digestive tract.
Babies with anorectal malformation may have a narrowed or missing anus. Or they may be born with a layer of tissue that blocks their anus or rectum. Some babies have irregular connections between their rectum and other parts of their bodies.
It can be concerning to learn that your baby has an anorectal malformation. Without treatment, babies can develop intestinal blockages, making it difficult or impossible to pass stool (poop). But these conditions are typically treated shortly after birth with good results. Usually, a surgeon repairs an anorectal malformation when your baby is a few days old.
The word “anorectal” is a combination of the words “anus” and “rectum.” Your rectum is the last part of your large intestine, just above your anus. Your anus is the opening where stool passes.
During a bowel movement, stool passes from your rectum through your anus and out of your body. Any problems with either your anus or rectum can cause problems with bowel movements.
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Anorectal malformations are rare. They occur in about every 1 in 5,000 babies born in the United States.
A healthcare provider usually spots an anorectal malformation during a newborn exam. They may notice a narrow or missing anus. Or your baby may have an anal opening in an atypical location.
If an anorectal malformation isn’t spotted right away, babies may experience symptoms like:
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There are several types of anorectal malformations, including:
Experts don’t know exactly what causes an anorectal malformation. Some think gene changes (mutations) that develop before birth may play a role.
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Sometimes, children with anorectal malformations have other health issues. Children with anorectal malformations may also have:
Healthcare providers diagnose an anorectal malformation during a physical exam. They may use imaging tests to get a closer look or confirm your child’s diagnosis, like:
Healthcare providers usually treat anorectal malformations with surgery. They may perform a single procedure to open a narrowed passageway or remove tissue that covers your child’s anus. They may also perform a procedure called an anoplasty to reconstruct their anus.
If babies have an imperforate anus, surgeons perform a series of procedures to join the rectum and anus. These surgeries include:
Children who had surgery to repair an anorectal malformation may have more difficulty with toilet training than others. They may have difficulty controlling their bowel movements or they may have long-term (chronic) constipation. Adults who had anorectal malformation surgery when they were babies may also experience sexual dysfunction later in life.
There’s no way to prevent having a child with an anorectal malformation. But you can help your child live a high quality of life after anorectal malformation treatment.
If you notice your child experiencing complications of treatment — like constipation — take them to their healthcare provider right away. Your child’s provider may prescribe laxatives, dietary changes or other treatments to relieve their symptoms. They may also recommend a bowel management program if your child has trouble controlling their bowel movements.
Anorectal malformations are more common in children assigned male at birth (AMAB) than in children assigned female at birth (AFAB).
People who already had one child born with an anorectal malformation are more likely to have another child with the condition. The chances that your future child will have an anorectal malformation is about 1 in 100 if you’ve already had a child with an anorectal malformation.
Most babies born with anorectal malformations are treated within the first few days of life. Many children heal well from surgery and have no complications.
Some children have long-term constipation or difficulty controlling their bowels after anorectal malformation surgery. Specialized treatment — like a bowel management program — can help.
Call your child’s healthcare provider right away if your baby:
If your child has an anorectal malformation or you think they could, you may also want to ask their healthcare provider:
A note from Cleveland Clinic
An anorectal malformation occurs when babies are born with an anus or rectum that didn’t develop properly before birth. It can be concerning to find out your baby has been born with a congenital condition. But surgery within a few days of birth usually treats the problem. The type of surgery your child needs depends on the type and extent of the malformation. Most babies heal well after treatment.
Last reviewed on 12/15/2022.
Learn more about the Health Library and our editorial process.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy