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Lateral internal sphincterotomy is the preferred method of surgery for persons with chronic anal fissures, and is generally used when medical therapy has failed. [1] It is associated with a lower rate of side effects than older techniques such as posterior internal sphincterotomy and anoplasty, [3] and has also been shown to be superior to topical glyceryl trinitrate (GTN 0.2% ointment) in ...
Because of the high incidence of internal anal sphincter thickening with the disorder, it is thought to be a disorder of that muscle or that it is a neuralgia of pudendal nerves. In one study of 68 people with proctalgia fugax, 55 had tenderness along the course of the pudendal nerve.
The internal anal sphincter is the specialised thickened terminal portion of the inner circular layer of smooth muscle of the large intestine. It extends from the pectinate line (anorectal junction) proximally to just proximal to the anal orifice distally (the distal termination is palpable). Its muscle fibres are arranged in a spiral (rather ...
“Pelvic musculature needs to completely relax, which involves the pelvic floor lowering into the toilet bowl and the internal anal sphincter opening up,” so stool comes out uninhibited, he says.
This injectable material has been used for treatment of grade III to IV prolapsed internal hemorrhoids, where it gives effects similar to hemorrhoidectomy. It has also been used for treatment of rectal prolapse and rectocele. [8] The material causes a local inflammatory reaction, followed by sclerosis and retraction of tissues.
[15] [16] Subconscious processes are controlled by the autonomic nervous system; these are involuntary movements such as contraction of the smooth muscle of the internal anal sphincter or the colon. The autonomic nervous system also provides sensory information; this could be about the level of distension within the colon or rectum.
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