Anal stenosis (anal stricture) is a rare condition. It’s when your anus is unusually narrow. Symptoms are constipation, narrow poops and pain when pooping. Babies may be born with anal stenosis. Adults often develop it after hemorrhoid surgery or if they have inflammatory bowel disease. Treatments are changing what you eat, medications or surgery.
Anal stenosis is a narrowing of your anus (butthole), the spot where poop leaves your body. Healthcare providers may use the term “anal stricture.” The condition most commonly affects adults as a complication of surgery or chronic disease, but babies may also be born with narrow anuses (congenital anal stenosis).
Anal stenosis symptoms can be mild, moderate or severe, but almost always involve not being able to poop. Most of the time, changing what you eat and medication ease anal stenosis symptoms. But if you have severe anal stenosis, you may need surgery.
Anal stenosis is rare, whether we’re talking about adults or congenital anal stenosis (CAS), but researchers are still gathering data on how often it happens.
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Constipation is the overarching symptom for anyone with anal stenosis. But babies and adults may have varying symptoms.
Adults may have constipation along with other symptoms like:
The most common symptom is when your newborn doesn’t pass meconium within 48 hours after they’re born. Other symptoms are:
Anal stenosis in adults happens when scar tissue builds up in your anus, adding a layer of tough, non-stretchy fiber to your anus’ walls so it becomes narrower. The scar tissue may develop after medical treatment or surgery in or near your anus. It can also happen if you have a chronic (long-term) disease that causes inflammation.
Studies show that 90% of anal stenosis cases involve scar tissue that builds up after hemorrhoid surgery. Issues that may cause scar tissue buildup include:
Anal stenosis in babies is a type of anorectal malformation that happens during fetal development. Experts don’t know the exact reason why.
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Complications depend on your symptoms. For example, if you have fecal incontinence, you may develop sores around your anus. If you have chronic constipation, you could develop fecal impaction. If your baby has CAS (congenital anal stenosis), they can develop dehydration.
Diagnosis steps are different for babies and adults:
Healthcare providers typically spot signs of congenital anal stenosis during a newborn examination that may include a digital rectal examination.
Your baby’s provider may suspect CAS if your baby doesn’t pass meconium within 24 to 48 hours after they’re born or if your baby’s first poops are unusually narrow. They may do the following tests to confirm your baby has CAS:
A healthcare provider will ask about your symptoms and your medical history. If you had surgery, they’ll review those records. They’ll do the following tests:
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Whether you have anal stenosis, or your baby does, initial treatments will involve steps you can take to make it easier for you to pass larger poops. A healthcare provider may recommend:
Sometimes, simply being able to pass stool that’s a normal size will stretch your anus naturally.
Your baby’s provider may do anal dilatation to gently stretch your baby’s anus. Anal dilatation involves placing a small, lubricated device (dilator) in your baby’s anus. The provider removes the dilator after a few seconds.
Your baby may receive this treatment twice a day for several weeks. Each week, they’ll use slightly larger dilators so your baby’s anus eventually reaches a normal size. Your baby will have fewer treatments for the next few months.
Rarely, babies with anal stenosis will need an anoplasty.
If changing what you eat or using laxatives doesn’t make a difference, your healthcare provider may recommend anal dilatation. They may do this treatment for you or show you how to use a dilator at home. They may recommend surgery if dilatation doesn’t improve your situation. Surgeries may be:
Treatment likely will help your anus return to its normal size and ease your anal stenosis symptoms. Unfortunately, anal stenosis often affects people with life-long inflammatory bowel disease (IBD). If that’s your situation, your healthcare providers will help you find ways to manage IBD.
Most of the time, treatment eases anal stenosis in babies. But as your baby grows up, be prepared to manage toddler constipation, particularly as your toddler masters toilet training.
If you have anal stenosis, your body’s probably been through a lot, like hemorrhoid surgery or managing an inflammatory bowel disease like Crohn’s disease. Anal stenosis may feel like one more challenge to your digestive health. Treatment may ease your symptoms. And here are some suggestions of things you can do to keep your poop moving:
Contact your provider if your anal stenosis symptoms don’t improve with treatment or if your symptoms get worse.
Here’s the bottom line: We all need to poop. But this can be difficult when you have a condition like anal stenosis, when your anus (butthole) narrows and normal-sized stools can’t come through.
If you have anal stenosis, you may feel like the symptoms are taking over your daily life.
If your baby has congenital anal stenosis (CAS), you may be upset and worried because they’re fussy or not feeding.
Fortunately, there are several ways to treat anal stenosis. Talk to a healthcare provider if you have anal stenosis symptoms or your baby does. The sooner you receive a diagnosis and treatment, the sooner you or your baby will feel better.
Last reviewed on 05/03/2024.
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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