Imperforate Anus and Anorectal Malformation in India: Causes, Diagnosis, and Treatment

Imperforate anus, also known as anorectal malformation in India (ARM), is a congenital birth defect that occurs when the anus and rectum do not develop normally during early pregnancy. In this condition, the baby’s anal opening — the passage through which stool exits the body — may be missing, blocked, or located in an abnormal position. As a result, the child is unable to pass stool normally, which can lead to bowel obstruction and other complications if not treated promptly.

Anorectal malformations occur in approximately 1 in 5,000 newborns and are slightly more common in boys than in girls. These defects develop in the first few weeks of fetal growth when the digestive and urinary systems are forming.

Types of Anorectal Malformations:

In babies with anorectal malformation, several structural abnormalities may be present, including:

  • Abnormally placed or narrow anal opening: The anus may be very small or located in the wrong position.
  • Absent anal opening with abnormal rectal connections: The rectum may connect to the urinary tract (urethra or bladder) or reproductive organs such as the vagina or vestibule. This can cause repeated infections and difficulty passing stool.
  • Cloacal malformation: In some female babies, the rectum, urinary tract, and reproductive organs form a single opening called a cloaca, where both urine and stool exit together. This is a complex and rare condition.

Early Detection and Diagnosis:

Doctors carefully examine newborns soon after birth to check the size and position of the anal opening. Most healthy newborns pass their first stool (meconium) within the first 48 hours. Failure to do so often raises suspicion of an internal abnormality.

Once an anorectal malformation is suspected, a detailed evaluation is performed to understand the anatomy and identify associated conditions. These tests may include:

  • Abdominal X-rays: To determine how far the rectum extends and assess the development of the lower spine and pelvis.
  • Abdominal ultrasound: To evaluate the kidneys and urinary tract, as these organs may also be affected.
  • Spinal ultrasound or MRI: To detect spinal abnormalities such as a tethered spinal cord, which can cause neurological problems like leg weakness or bowel and bladder incontinence later in life.
  • Echocardiography: To screen for congenital heart defects, which may coexist with anorectal malformations.

Anorectal Malformation in India: Treatment Options:

The treatment of anorectal malformation is surgical and must be performed by an experienced pediatric surgeon. The type and number of surgeries depend on the severity of the defect, the child’s anatomy, and associated health conditions.

Some children may undergo single-stage corrective surgery, while others require multiple-stage procedures. In severe cases, a temporary stoma (colostomy) is created on the abdominal wall to divert stool and protect the intestine before definitive reconstruction is performed.

Selecting the Best Pediatric Surgeon in India is critical, as these surgeries require advanced expertise to reconstruct the anatomy while preserving bowel, urinary, and sexual function.

Long-Term Care and Bowel Management:

Even after successful surgery, some children may have challenges with bowel control. The nerves and muscles responsible for sensing stool and maintaining continence may be underdeveloped or damaged. Therefore, a structured bowel management program is often started during toilet-training age to help the child achieve social continence and improve quality of life.

With proper surgical care, follow-up, and bowel training programs, many children with anorectal malformations grow up to lead healthy and active lives.

#Anorectal Malformation In India #Hypospadias Surgery In Delhi

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Location: Delhi, India

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