An imperforate anus happens when the anus is missing or doesn't have a hole. The
anus is the muscle ring that lets a person hold poop inside, then release it later
during a bowel movement (BM). Imperforate anus is a type of birth defect called an
anal malformation. This means that the anus and rectum don't form
in the usual way. Anal malformations have different effects in boys and girls.
A baby born with an imperforate anus has problems with:
the anal opening, where poop leaves the body
the rectum, the section of large intestine above the anus
the nerves that tell the body when it's time to have a BM
This means the baby has trouble having normal BMs.
What Causes an Imperforate Anus?
Each year, 1 in every 5,000 babies are born with an imperforate anus (im-PER-fer-it
AY-nus). Doctors don't know exactly what causes it. A baby's digestive
tract forms during early pregnancy. After birth, whatever a baby eats that's not
absorbed by the digestive tract turns into poop (feces or stool). Then it passes out
of the body through the anus.
The anal sphincter (SFINK-tur) is a group of muscles in the anus that controls
the release of poop. In an imperforate anus, the anal sphincter usually forms in the
right place, but without the normal opening. When this happens, the rectum might be:
covered by tissue or a membrane
open in the wrong place
What Are Some Types of Imperforate Anus?
An anus that forms without an opening is called anal atresia.
Another type of anorectal malformation, when the rectum opens in the wrong place,
has different names, depending on the parts of the body affected:
A rectoperineal fistula (opening) on the skin behind the genitals
(an area called the perineum).
Boys may have a rectourethral fistula, which connects the rectum
to the urethra, the urine (pee) tube. Both pee and poop come out of the urethra's
opening, which is usually at the tip of the penis.
making a treatment plan based on how the baby's anus and other parts formed
Most infants with imperforate anus will need surgery to fix the problem.
A common repair is a posterior sagittal anorectoplasty (PSARP). It's done when
the surgeon knows the location of the organs in the abdomen and where the rectum ends.
The doctor will make an incision (cut) between the baby's butt cheeks, then disconnect
the rectum from the urinary tract or vagina and place it within the anal sphincter.
At some point, the baby might need a temporary colostomy. Colostomy means that the
bowel movement (poop) goes into a bag that is outside the skin.
What Else Should I Know?
Many children with imperforate anus will have trouble with pooping. Some may have
trouble holding their urine. Routine visits with the doctor can help with these issues.
A continence clinic (a clinic that treats children who have bowel
or bladder problems) can help children and families overcome the physical, mental,
and social challenges that may follow the surgical repair of an imperforate anus.
Being involved in your child's care plan can help you feel more in control:
Take things one day at a time.
Look to your care team to guide you on caring for your child, getting ready for
surgery, recovery, and more. If you have questions, ask.
Accept help when you can, and lean on those around you for support.
You also can find more information and support online at: