[Anorectal dyschezia. Megarectum].

Anorectal dyschezia is due to a defect in the coordination between the forces which try and expel the stool and the relaxation of the anus. There are two types: congenital and acquired. In the first case, there is a distal aganglionic zone; these are in fact cases of Hirschsprung's disease. In the acquired cases, the mesenteric plexuses are normal and the aetiology lies in the painful process which affects the anus. Forced dilatation is the only treatment for anorectal dyschezia and it should replace the use of sphincterotomy. In cases of acquired dyschezia, medical treatment consisting of curing the anal cause of the pain, evacuating the rectum of faecalomas, lubricating the faeces recommending the use of a laxative, is successful in the majority of cases. In cases unresponsive to this treatment, forced dilatation of the anus will help achieve cure. We present 255 cases of anorectal dyschezia: 17 cases were congenital and 238 were acquired. In the first group, good results were obtained with forced dilatation in 14 cases. In the second group, this procedure had to be performed in 23 patients for whom medical treatment was unsuccessful. It resulted in remission of symptoms in 20 cases.