Anal stenosis is a frequent complication of Crohn’s disease and is associated with a significant impairment in patients’ quality of life. Endoscopic, manual, or surgical anal dilatations are commonly employed as therapeutic interventions; however, their impact on quality of life remains insufficiently explored. The aim of this study was to assess the improvement in quality of life among patients with Crohn’s disease–related anal stenosis following dilatation, based on clinical symptomatology and Inflammatory Bowel Disease Questionnaire (IBDQ) score before and after the procedures.

We conducted a retrospective descriptive study between 2018 and 2025 in the Department of Hepato-Gastroenterology and Proctology. All adult patients (aged >16 years) with anal stenosis secondary to Crohn’s disease who underwent dilatation (manual, endoscopic, or surgical) were included. Patients who received other therapeutic modalities for stenosis or who had incomplete medical files were excluded.Quality of life was assessed using the IBDQ before and after the procedure. Clinical data were collected regarding stenosis progression, type of dilatation, average number of sessions, success and failure rates, and recurrence.

Among the 33 patients with Crohn’s disease related anal stenosis, 15 (45.45%) underwent a dilatation procedure. The male-to-female ratio was 1.14 (8 men, 7 women), with a mean age of 47 years (range: 24–74). The mean interval between Crohn’s disease diagnosis and the need for dilatation was 11 years.Five patients (33.3%) underwent endoscopic dilatation, ten (66.7%) manual dilatation, and four (26.7%) surgical intervention.

Before dilatation, clinical symptoms included: spontaneous proctalgia in 4 patients (12.1%), defecation induced proctalgia in 7 patients (21.2%), and fecal incontinence in 6 patients (18.2%). One patient (3%) was asymptomatic, while 7 patients (21.2%) reported a sensation of incomplete evacuation.

Among the 15 patients, 13 (86.67%) expressed satisfaction and reported a significant improvement in quality of life after dilatation, along with reduction of symptoms.Analysis of IBDQ score showed an overall mean improvement of 33 points following dilatation. A Student’s t-test confirmed that this difference was highly statistically significant (p < 0.001).When comparing dilatation techniques, endoscopic dilatation resulted in a mean IBDQ increase of 47 points (p = 0.003), whereas manual dilatation showed a mean increase of 20 points, which did not reach statistical significance (p = 0.102).

Disease progression after dilatation was marked by recurrence of stenosis in 13 patients (86.67%), with a mean recurrence interval of 129 days. Recurrence was particularly frequent among those who underwent manual dilatation, accounting for 80% of cases.

According to our study, dilatation of anal stenosis in Crohn’s disease leads to a significant short-term improvement in patients’ quality of life. However, recurrence management remains challenging. Prospective multicenter studies with long-term follow-up are needed to better elucidate the sustained effects of this procedure and refine therapeutic strategies.