Atresia ani or also called imperforate anus is one type of defect or abnormality that occurs since birth. This condition indicates that the development of the fetus is disturbed so that the shape of the rectum (the last part of the large intestine) to the anus is generally not formed perfectly.
In addition, this disorder can also occur in other areas of the body, such as the digestive organs, urinary tract, and genitals. Generally, atresia ani is categorized as follows:
- Lower-level abnormalities, namely a narrowed or completely closed anus due to the rectum still attached to the skin. A closed anus is generally accompanied by other birth defects, such as heart disorders, central nervous system problems, or hand and foot anomalies.
- Upper-level abnormalities, namely the position of the large intestine located in the upper pelvic cavity and the formation of a fistula connecting the rectum and bladder, urethra, or vagina. A fistula itself is an abnormal tunnel that appears between two normal channels, such as between blood vessels, intestines, or organs.
- Persistent posterior orifice or cloaca, which is an abnormality that causes the rectum, urinary tract, and vaginal opening to meet in one channel.
Symptoms of Atresia Ani
An atresia ani disorder is characterized by the shape of the rectum reaching the anus in babies that cannot develop perfectly. This health problem also has several forms, including:
- A narrowed or completely closed anus.
- The rectum is not connected to the large intestine.
- The formation of a fistula or channel that connects the rectum and bladder, urethra, vagina, or base of the penis.
If the fetus develops normally, the development of the anus, urinary tract, and genital organs in the fetus will generally begin to occur in the first trimester of pregnancy or at 7 to 8 weeks of age.
Well, when the development of the organ is disrupted, eating is called atresia ani. Babies with atresia ani usually show the following symptoms:
- The anus is not in the right place or the child is born without an anus.
- The position of the anus is too close to the vagina if anal atresia occurs in baby girls.
- Meconium or the first feces that should come out of a baby after birth does not come out between 24 and 48 hours after the baby is born.
- The baby’s stomach looks enlarged.
- Feces come out of the vagina, scrotum, base of the penis, or part of the urethra.
Causes of Atresia Ani
Atresia ani can be said to be one form of congenital disability. Unfortunately, what causes this condition is still unknown.
Atresia ani can occur randomly and affect anyone. However, there is also a hypothesis that links this health problem to a genetic defect.
It should be noted that anal atresia can occur simultaneously with a health condition called VACTREL or Vertebral Defects, Anal Atresia, Cardiac Defects, Tracheoesophageal Fistula, Renal Anomalies, and Limb Defects. These conditions are a collection of congenital abnormalities that can affect various systems in the body.
When the fetus experiences disorders or abnormalities in the development of the digestive tract, the mother’s pregnancy can also be disturbed. One condition that is very often associated with the problem of atresia ani in pregnant women is polyhydramnios, a condition when the level of amniotic fluid is excessive during pregnancy.
Annual Atresia Risk Factors
It is not yet known for certain whether there are factors that increase the risk of atresia ani in children or not. However, the following are thought to increase the risk of atresia ani in babies:
- Male gender.
- Having other birth defects.
- Use of inhaled steroids during pregnancy.
Diagnosis of Atresia Ani
When a baby is born, the doctor, assisted by medical staff, will perform a thorough diagnosis of anal atresia, including ensuring whether or not there is an anus.
If during the examination no anus is found, the doctor will immediately carry out various further tests to ensure the baby’s health condition.
Because it is a birth defect due to problems with fetal development, anal atresia is usually accompanied by many other birth defects, such as:
- Disorders that occur in the kidneys and urinary tract.
- Abnormalities that occur in the spine.
- Disorders that occur in the respiratory tract organs.
- Abnormalities that occur in the esophagus.
- Abnormalities that occur in the legs and arms.
- Having congenital heart disease, Hirschsprung’s disease, Down syndrome, and duodenal atresia.
To help detect congenital defects that often occur with anal atresia, doctors will usually perform several other supporting tests, such as:
- Ultrasound, X-ray, and MRI scans are used to detect bone problems and to thoroughly examine the throat, esophagus, and other organs.
- Echocardiography examination to determine the health condition of the baby’s heart.
Ani Atresia Treatment
Treatment for anal atresia is done with the aim of helping to improve the condition of the anus in babies so they can live a normal life. Before further treatment is carried out, babies who do not have an anus will be given fluids and nutrients through IV fluids.
Then, if a fistula forms in the urinary tract that increases the risk of infection, doctors will generally prescribe antibiotics. Generally, treatment options that can be done to help treat anal atresia are:
1. Surgery or Operation
Surgery is the primary treatment option for treating anal atresia. The goal is to restore the digestive tract to normal function. The type of surgery is based on the symptoms, type, age, and complexity of the form of anal atresia that appears, as well as the baby’s health condition. Some surgical options that can be done to treat anal atresia are:
- Colostomy, which is a procedure to create a hole or stoma in the abdominal wall to be used as a temporary waste channel. Later, the waste that comes out of the stoma will be collected in a bag called a colostomy bag.
- Pull through, a surgical procedure performed to connect the anus and rectum. Generally, this surgical procedure is only performed a few months after the first colostomy surgical procedure.
- Colostomy closure, is a further surgical procedure performed to close the stoma opening. As a result, people with anal atresia can begin to pass waste that is then eliminated through the rectum and anus.
- Perineal anoplasty, is a surgical procedure performed to close a fistula that connects to the urinary tract or vagina. The procedure is performed to ensure the anus is in the correct position.
It should be noted that the success rate of surgical procedures to correct anal atresia is quite high.
2. Diet and Eating Patterns
After undergoing surgical procedures, people with atresia ani are advised to regulate their diet and eating patterns. For example, increasing fiber-rich intake and taking supplements and vitamins. Of course, this is to prevent sufferers from constipation.
Complications of Ani Atresia
Untreated anal atresia can trigger a series of serious complications. However, surgery can also cause complications, such as:
- Constipation.
- There is a perforation or tear in the intestine.
- Having a urinary tract infection.
- Experiencing urinary or fecal incontinence.
- There is stenosis or narrowing of the anus.
Prevention of Atresia Ani
Atresia ani is a congenital condition or birth defect, so its occurrence is certainly difficult to prevent. However, there are several things that pregnant women can do to reduce the risk of abnormalities during pregnancy, namely:
- Undergo genetic testing if there is a history of atresia ani or other congenital problems before planning pregnancy.
- Eat healthy foods, do not smoke, and do not consume alcoholic beverages or drugs not prescribed by a doctor during pregnancy.
- Have regular pregnancy check-ups and make sure you take all supplements from your doctor.
When to See a Doctor?
Take immediate action if the baby is known to have atresia ani. Don’t forget, to routinely have a health check with a doctor to prevent this birth defect from happening.