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Anal Stenosis
Anal stenosis refers to narrowing of the anal sphincter and opening. The
most typical first symptoms, not surprisingly,
are narrowing of the stool and difficulty or resistance moving the
bowels. If this
begins to happen, either coming on abruptly
or slowly, this is the time to be concerned.
It’s a quiet condition that leads to many other conditions
because it causes a patient to push or strain
to move the bowels and that pressure directly causes hemorrhoids – but
that’s just the start. For one thing, hemorrhoids further
narrow the passage or opening, so the stenosis becomes worse, and
the pressure and pushing when eliminating increases. Something
has to give and the opening can easily tear or split, which is to
create a fissure. In fact stenosis
is the biggest reason why fissures develop.
To back up a minute, there are three ‘levels’ of the
anal spincter and any or all of them can become tight. The
outer two you control consciously and the inner ring, more part of
the rectum, isn’t under conscious control. That’s
the one that usually becomes stenotic.
Rectal stenosis (or proctostenosis) is similar to anal stenosis
but deeper – it’s a narrowing of the rectal canal. Usually
a stenotic patient will have both and just be tight all the way through.
Stenosis has always been treated, believe it or not, by simply cutting through
one side of the sphincter to relieve the tension. Called a
sphincterotomy, it simply defeats the action of a sphincter muscle
which is to close, and has the side effect, of course, of fecal incontinence
or leaking of fecal matter. It’s a barbaric procedure
left over from an earlier age.
Let’s be glad there are alternatives. I have developed
a unique procedure that I call the Cranford
Technique and I believe I’m still the only person who performs
it (until I teach it and license it to another
doctor). What
I’ve learned is that a narrowed sphincter, even one with true
stenosis, can be manually dilated, under
anaesthesia, to open it back up to original
size. Then it's treated topically
so the muscle gets used to staying open.
Then any fissures, for example, can be removed and the area can
heal from the inside out. Hemorrhoids can be treated and shrunk
more easily and quickly. It has excellent long-term results,
and to top it off, is fairly painless to the patient. Compare
that to a sphincterotomy, which entails long-term surgical pain,
persistent bleeding, leaking, etc. To be honest, I’m
not aware of any viable alternative to the procedure I’ve developed
for this combination of stenosis and fissures.
I’ve even had good results with patients who have already
had sphincterotomies.
Cranford Technique
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