Patient: My son was born on August 30, 2010, the same day found to be anal atresia, is 2.4cm, the next day in Guangxi Medical University to do a stoma, to the baby’s 8 months of age to do a combined operation of the 2nd and 3rd (when the doctor recommended is 6 months to do the second phase of the family, we have a little thing happened), the surgical method is not laparoscopy is not the path, is the stoma and then open a larger point of the intestines to pull to the The anus to do artificial anus surgery 3 weeks after surgery to expand the anus, according to the doctor’s instructions is to expand the anus once a day, each time for 10 minutes, now 8 months after surgery, expanding the anus to the 16th, the baby every day to take a long time to pull a clean poop, often intermittent pull, this time pulling a sticky stool, a little bit of it out, the feeling is that the overflow, could it be that the baby’s intestinal peristalsis can’t do it? Is this considered incontinence? Is this a normal phenomenon after surgery? If not, what should I do? Li Jinliang, Department of Pediatric Surgery, Second Hospital of Shandong University: Hello. Your child has postoperative bowel dysfunction after abdominal perineal anoplasty. He may have difficulty in defecation, incontinence or both, and from your description, you can guess that the former is more likely to be the case. There are 4 main causes of difficult defecation or constipation: colorectal ganglion cell dysplasia or ganglion cell deficiency (congenital megacolon and its analogous rim disease), congenital dysplasia or injury of the anorectal muscles, functional defecation disorders (e.g., slow-transmitting, outlet-obstructing) and others such as sigmoid colon redundancy, and scarring anal stenosis. There are three causes of fecal incontinence: congenital or acquired dysplasia or deficiency or injury of the external anal sphincter, congenital or acquired dysplasia or deficiency or injury of the internal anal sphincter, and functional fecal incontinence. All of the above conditions can exist separately or at the same time, so you need to come to the hospital to do physical examination, pelvic floor muscle MR, anorectal manometry, colonic transmission test, anorectal inhibitory reflex, barium enema or defecography or even biopsy, etc., and then to determine whether the surgical treatment (eg, sphincter reconstruction, anorectal muscle reconstruction, resection of the lesion of the colon, etc.) or conservative treatment such as electrostimulation, biofeedback training, etc..