Rectal stricture

22. Rectal stricture blog
Rectal stricture is a condition where the rectal or anal opening is narrowed due to the presence of scar tissue from inflammation, a previous injury, or an aggressive cancer growth.

Patient with rectal stricture complain of difficulty in passing stools, straining at stool & occasionally blood in stool. Sometimes the caliber & consistency of the stool changes. Some may develop bloating & inability to pass stools if the disease is advanced.

Following are some of the causes of rectal stricture:

  • Ulcerative colitis
  • Crohn’s disease
  • Radiation proctitis
  • Cancer

The diagnosis of a rectal stricture is based on history, physical examination, and, occasionally, imaging findings. The degree of a stenosis is best imaged with a water-soluble contrast enema. Computed tomography and magnetic resonance imaging, with or without rectal contrast enhancement, can be helpful in assessing other segments of the alimentary tract or the peritoneal cavity for conditions such as IBD and cancer.

Rectal Stricture treatment is usually based on the cause and severity of the condition. The following covers the most common treatment methods, including non-operative management.
  • Dietary Adjustments: This is for mild anal stenosis and can include eating foods with more fiber, which can make stools larger.
  • Stool Softeners: For mild to moderate anal stenosis, this can help stretch a mild stricture.
  • Anal Dilation: This is a way to stretch the anal canal. It involves placing your index finger into the anus two times a day for about two months to help stretch the area. In severe situations, this can be done at a hospital.
  • Steroid Injection: When injections are made right into a scar it can potentially reduce recurrence of stricture.
  • Botox: Injections of Botox have been known to help stenosis caused by spasm.
  • Surgery: Two surgical options are sphincterotomy, which is used to repair fissures, or Sphincteroplasty, which is a flap procedure whereby healthy tissue is used replace a defective area after scar tissue has been removed.
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Dr. Harsh J Shah