Question about anal sphincter ?

Question

When my neighbors son was six months old he had to have the outer sphincter dialted so he could have a bowel movement. He's 7 now and says the best word to describe is " no feelings" when he needs to have a bowel movement, no cramping , no urges to go,upon a recent exam, he was able to tighten the muscle when asked to do so.Hes never constipated or never has loose bowels. What could be the problem ? The only medical problem he has is ADHD.

Answer 1

Sometimes, the fetus' lower intestine does not "reach" all the way to the hiney.  This is called an imperforate a**s... meaning simply there is no anal perforation... or hole.  

This condition has many degrees and it sounds like your little neighbor's r****m, a**s and sphincter were underdeveloped at birth.  The "dilation" was most likely to relieve constipation.

As he matures, one would expect his muscle control to improve, as well as his awareness of needing to have a bowel movement.  However, it sounds like his r****m may be so underdeveloped that he doesn't fully experience the peristaltic contractions that a fully-developed bowel does.

Anyways, all that being said, I'm not sure what your question is.  You said he isn't constipated and doesn't have lose bowels, but you didn't say if he is fecal (or bowel) incontinent.

His lack of sensation or the "urge" to go to the restroom is a result of the underdeveloped lower intestine.  Sounds like he's at the age where he can regulate his diet and know his body's typical timing for bowel movements, or "flush" himself with a bulb syringe/e***a so as not to have any "accidents."  As he continues to mature, he may be able to sense pressure or other feelings that preceed his need to go to the restroom.

Anyways, the condition, in all its varying degrees, is more common than you might think.