Value of an anal dilator after anal stretch for haemorrhoids

A prospective randomized trial compared anal stretch with or without continued dilatation for three months in 89 consecutive patients with haemorrhoids. Complications of therapy occurred in only 4 patients, 3 of whom had transient incontinence of flatus. When patients were reviewed four months after treatment, only 4 of 44 patients (9%) who used a dilator had not been improved and required additional therapy, compared with 15 of 42 patients (36%) who had anal stretch alone (P less than 0.02). It is concluded that the use of an anal dilator improves the results of anal stretch.