Abertura anal 1/3 do tamanho normal causando problemas incontáveis - qual cirurgia para corrigir

My 70-year young Dad has anal opening 1/3 the normal size

Imagine having to pass stool through an anus 1/3 the normal size

And imagine all the problems that are created because of this narrow opening!

Please tell what surgery will correct this once and for all.

I uploaded two graphics (I'm more artistic and visual) to help describe the issue.

Below is written background info

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This started with Piles surgery in 1965 (when he was in India). Surgery went well, my Dad was able to eat anything.

Over the decades, scar tissue around anus became hard and narrowed it.

In 2008 (in USA) my Dad underwent surgery to attempt to widen the anal opening. Unfortunately the colon-rectal surgeon made the anal opening even more narrow.

Other Doctors later told my Dad the colon-rectal surgeon should have never attempted this surgery.

My Dad regrets having this surgery because it severely decreased his quality of life.

First off, my Dad has 100% fiber diets (he misses all the foods like pizza, dosa, etc), drinks plenty of water, has fiber powdered supplements.

Instead my dad has painful, burning, bleeding bowel movements. In past several months he developed bleeding internal hemorrhoids.

In Oct 2017 when another colon-rectal surgeon prescribed Topical Compound of Diltiazem, Lidocaine and Hydrocortisone to treat anal ulcers, it caused severe anal pruritus. 

Now my Dad is scared to to Bowel Movement,and tears come out of his eyes. Even splashing water on his anus (to clean up after bowel movement) is painful and debilitating.

And because anal opening is narrow, it doesn't completely eliminate stool. Hence it stays in rectum, gets hardened, and contributes further to constipation, further to discomfort.

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It is disheartening to see my Dad in so much pain.

I have read your horror stories on these forums hemorrhoid surgeries (my Dad has bleeding internal hemorrhoids) which at best will only treat the surface of the problem, i.e my Dad has anal opening 1/3 of normal size.

Going to the Doctor is not like going to a picnic.

I understand Doctors have very little time for patients due to our system. They spend years studying to go into medical school, have to endure "bullying" during their 3rd and 4th years. And during residency, many of them are suicidal due to lack of sleep, bullying from nurses, troublesome patients.

I totally get that

Please point me in the right direction.

What surgery can my Dad consider to fix this problem once and for all?

We want to have good, informed information before Dad's next doctor's appointment (hope weather will get warmer and tolerable outside)

Olá, encontrei seu post… e só posso esperar que tudo tenha se acalmado para seu pai desde então.

Tenho uma situação semelhante, mas diferente, na qual, devido ao fato de ter músculos do assoalho pélvico hiper tônicos e hiperativos, isso faz com que o canal anal se torne estreito e, portanto, desencadeie hemorroidas e fissuras anais.

A dor tem sido incessante e causou muitas lágrimas (7 meses).

Recentemente, venho usando a pomada de diltiazem!!! E, após 2 semanas, começo a sentir um alívio.

Ainda são dias iniciais… mas esperando que isso seja um sinal positivo de que as coisas voltarão ao normal!