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Reflex anal dilatation

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Reflex anal dilatation (RAD) refers to the reflexive dilation of the anus to a diameter greater than two centimeters in response to the parting of the buttocks or anal stimulation such as being brushed with a medical instrument. RAD was theorized to be a clinical marker associated with anal sexual assault in children,[1] and has been associated with other signs of sexual assault[2] but also appears in children with severe chronic constipation and those subject to invasive medical treatments of the anus.[3] The finding of RAD alone is not considered indicative of sexual abuse,[4] and a normative sample of children not suspected of having been sexually abused found that a significant number of children showed anal dilatation either continuously or intermittently.[5]

Used extensively in the Cleveland child abuse scandal, it was discredited during the trial as the sole indication of sexual abuse, determined to be considered a sign of sexual assault by a tiny minority of British physicians.[6] RAD is now considered discredited.[7]

See alsoEdit


  1. Read NW, Sun WM (June 1991). Reflex anal dilatation: effect of parting the buttocks on anal function in normal subjects and patients with anorectal and spinal disease. Gut 32 (6): 670–3.
  2. Bruni M (November 2003). Anal findings in sexual abuse of children (a descriptive study). J. Forensic Sci. 48 (6): 1343–6.
  3. Clayden, G (1988). Reflex anal dilatation associated with severe chronic constipation in children. Arch Dis Child 63: 832–836.
  4. Brittain, Charmaine; American Medical Association (2006). Understanding the medical diagnosis of child maltreatment: a guide for nonmedical professionals, 126, Oxford [Oxfordshire]: Oxford University Press.
  5. McCann J, Voris J, Simon M, Wells R (1989). Perianal findings in prepubertal children selected for nonabuse: a descriptive study. Child Abuse Negl 13 (2): 179–93.
  6. Ashenden, S (2004). Governing child sexual abuse: negotiating the boundaries of public and private, law and science, 144-153, Routledge.
  7. Liz Bonner; Mandy Wells (2007). Effective Management of Bladder and Bowel Problems in Children, 75, Class Publishing.

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