Laxity of the anus and anal dilatation may be found with neurologic disorders, the effects of general anesthesia, and chronic constipation. Anal dilatation is considered a normal reflex if stool is present in the rectal vault.

Anal laxity and dilatation may be consistent with sexual abuse but are considered unclear findings for sexual abuse.

Childhood sexual abuse is a problem of epidemic proportions affecting children of all ages and economic and cultural backgrounds. Although awareness of child abuse is increasing, it may be challenging to differentiate findings attributable to sexual abuse from those of other benign conditions.