Anorectal stricture
Anorectal stricture: Excerpt from Professional Guide to Diseases (Eighth Edition)
In anorectal stricture, also known as anorectal stenosis or contracture, the anorectal lumen size decreases and stenosis prevents dilation of the sphincter.
Causes
Anorectal stricture results from scarring after anorectal surgery or inflammation, inadequate postoperative care, or laxative abuse.
Signs and symptoms
The patient with anorectal stricture strains excessively when defecating and is unable to completely evacuate his bowel. Other clinical effects include pain, bleeding, and pruritus ani.
Diagnosis
Visual inspection reveals narrowing of the anal canal. Digital examination reveals tenderness and tightness.
Treatment
Surgical removal of scar tissue is the most effective treatment. Digital or instrumental dilatation may be beneficial; however, this procedure may need to be repeated frequently and may cause additional tears and splits. If the cause of stricture is inflammation, correction of the underlying inflammatory process is necessary.
Special considerations
Patient care consists of preoperative and postoperative support.
❑ Prepare the patient for the digital examination and testing by explaining procedures thoroughly.
❑ After surgery, check the patient’s vital signs often until he’s stable. Watch for signs of hemorrhage (excessive bleeding on rectal dressing).
❑ If surgery was performed under spinal anesthesia, record the first leg motion, and keep the patient lying flat for 6 to 8 hours after surgery.
❑ When the patient’s condition is stable, resume his normal diet, and record the time of his first bowel movement. Administer stool softeners, as ordered. Give analgesics, provide sitz baths, and change the perianal dressing, as ordered.
Book Source Details
- Book Title: Professional Guide to Diseases (Eighth Edition)
- Author(s): Springhouse
- Year of Publication: 2005
- Copyright Details: Professional Guide to Diseases (Eighth Edition), Copyright © 2005 Lippincott Williams & Wilkins.
More About Anorectal disorders
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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
» Next page: Rectal pain (Professional Guide to Signs & Symptoms (Fifth Edition))
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