Anal Dilatation - Guide for patients

Introduction

Your consultant has recommended that you use anal dilators to treat the tightness of your anal muscle.

A Clinical Nurse Specialist (CNS) trained in the use of anal dilation will teach you how to perform anal dilation safely. Patients who have undergone ileoanal pouch formation must not use anal dilators except under direct supervision and instruction of the surgeon who performed the surgery.

Anal dilators are for single patient use only and are available in various sizes (small to large).

Most dilators are used at room temperature.

Your CNS will discuss with you which dilator size is most suitable for your needs.

To use an anal dilator, you will need:

• Dilator of the appropriate size and type
• Water based lubricating gel
• Tissues / wet wipes
• Area of privacy and comfort (bedroom or bathroom)

Directions for use:

In most cases the dilator can be used at room temperature. Your CNS will provide you with any specific instructions should cooling or warming of the dilator be indicated.

Find a comfortable position

Many patients prefer to lie on their left side or sit on a bidet. However, any comfortable position is appropriate. Dilators can be used with either a full or empty bowel. Sitting in warm water or a warm bidet prior to insertion will help relax the anal sphincter muscles and assist insertion.

Lubricate the anus / bottom and the tip of the dilator

Proper lubrication will help prevent potential tearing or discomfort due to dryness. Do not use a petroleum – based lubricant because it will increase your risk of infection and be more difficult to wash off.

Insertion: Lightly use the tip of the dilator and hold it to the outside of the anus. Exhale and gently ease the dilator into the anal canal. Breathing deeply, inching the dilator deeper with each exhalation to aid insertion.

Do not continue if you become tense: Practice controlled breathing and attempt to relax.

Remove the dilator if there is any chance you might become hurt or injured.

If spasm occurs (tightening of the anus), sitting in warm water or warm bidet prior to insertion will help to relax the anal sphincter muscles and assist insertion.

The dilator is fully inserted once the cuff (the flat end) is in contact with the skin: Leave it in place for 30 -60 seconds. Remove it slowly. It is not advisable to try to stand or walk.

Wash and dry the dilator thoroughly: Hygiene is important to avoid risk of infection during the next use of the rectal dilator. Use a mild hypoallergenic soap and warm water. If necessary, leave for several hours in a disinfectant solution e.g. Milton.

Schedule for use of anal dilator: In cases of anal stenosis, twice daily use of the dilator is advisable. Treatment should be continued for several months.

Please do not hesitate to contact us sooner if you have any questions or concerns relating to your use of anal dilation.

Risks

• Rectal perforation – characterised by significant bleeding per rectum, acute / severe abdominal or back pain post dilation, development of fevers / feeling generally unwell.
• If you experience any of these symptoms seek medical advice straight away or attend Accident and Emergency.
• Whilst rectal perforation is uncommon the consequences can be life threatening and may include emergency surgery and stoma formation.
• Pain/ discomfort to the anus at time of insertion.
• Trauma to the anus.
• Small amount of blood on the dilator.

MyChart

We would encourage you to sign up for MyChart. This is the electronic patient portal at Cambridge University Hospitals that enables patients to securely access parts of their health record held within the hospital’s electronic patient record system (Epic). It is available via your home computer or mobile device

More information is available on our website.

Contacts/Further information

Colorectal and Stoma Department 01223 216505

Additional sources of information:

• Bladder and Bowel UK (opens in a new tab) 0161 214 4591
• Disabled Toilet Access The RADAR National Key Scheme (NKS) was designed to address this problem. You can order a RADAR key from a number of organizations and retailers, including the Disability Rights UK (opens in a new tab)

Privacy & dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and/or specialist one to one care is required.