Tier 2 keto with anal disorders can be divided into two categories, one of which is related to defecation, the other with local symptoms.Among the defecation problems there are:stool incontinencechronic constipation (these may be due to a slow intestinal passage, as well as an abnormal function of the rectum itself and pelvic floor muscles)Local ailments include:pain in the anus area , present constantly, during or after defecationsoft tissue swellingThese symptoms often disturb patients and are a common reason for going to the GP for follow-up.