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The external anal sphincter (or sphincter ani externus) is an oval tube of skeletal muscle fibers. [1] Distally, it is adherent to the skin surrounding the margin of the anus. [2] It exhibits a resting state of tonical contraction [1] and also contracts during the bulbospongiosus reflex. [3] [4] [5] [6]
This results in less smooth muscle contraction of the colon, increasing the colon transit time. [12] The reduced dopamine levels also causes dystonia of the striated muscles of the pelvic floor and external anal sphincter. This explains how Parkinson's disease can lead to constipation. [14]
To top it off, the anal sphincter will contract once the skin is irritated on the outside. “This is an involuntary muscle, so even with bowel movements, the muscle will not relax,” Pannell said.
Two more highly common causes of functional anorectal pain are levator ani syndrome (LAS) and proctalgia fugax.Both of these conditions are thought to be caused by muscle spasms of the either the levator ani muscle or the anal sphincter muscle respectively, and may overlap symptomatically with a third less-common condition called coccygodynia which is the result of previous trauma to the ...
“When systemic and chronic inflammation accompanies these underlying diseases, it can affect multiple organ systems, manifesting as fatigue, muscle weakness, digestive disturbances, joint pain ...
Nontraumatic conditions causing anal sphincter weakness include scleroderma, damage to the pudendal nerves, and IAS degeneration of unknown cause. [5] Radiation-induced FI may involve the anal canal as well as the rectum, when proctitis, anal fistula formation, and diminished function of internal and external sphincter occur. [2]
Generally, fissures are due to injury to the mucosa, or because of a poor local blood supply that prevents proper healing, with spasm of the external anal sphincter contributing. [9] The external anal sphincter can be relaxed by the application of glyceryl trinitrate creams, and constipation is managed with laxatives and improving hydration. [9]
The pelvic floor are the muscles that attach to the pelvis in the abdomen. Anal sphincter dyssynergia can be caused by obstructions, but mostly improper relaxing of the anal sphincters or pelvic floor muscle during defecation. Also if there is a decrease in intrarectal pressure defecation can occur. [5]