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The internal anal sphincter is not under voluntary control, and in normal persons it is contracted at all times except when there is a need to defecate. This means that the internal anal sphincter contributes more to the resting tone of the anal canal than the external anal sphincter.
Two sphincters control the exit of feces from the body during an act of defecation, which is the primary function of the anus. These are the internal anal sphincter and the external anal sphincter, which are circular muscles that normally maintain constriction of the orifice and which relax as required by normal physiological functioning. The ...
Defects of the external anal sphincter are associated with urge incontinence. [22] The external anal sphincter is supplied by the pudendal nerve. Damage to the nerve supply of the external anal sphincter on one side may not result in severe symptoms because there is substantial overlap in innervation by the nerves on the other side. [2]
Reflexive relaxation of the external anal sphincter is also triggered. [37] For defecation to occur, rectal pressure must be greater than pressure in the anal canal, which depends on the relaxation of the external anal sphincter, the puborectalis and the intra-abdominal force applied. [37]
To be considered functional constipation, symptoms must be present at least a fourth of the time. [6] Possible causes are: Anismus; Descending perineum syndrome; Other inability or unwillingness to control the external anal sphincter, which normally is under voluntary control; A poor diet; An unwillingness to defecate
[15] 10th-century Persian physician Haly Abbas was the first to highlight preserving the sphincter muscles throughout the surgery and the prevention of strictures with a stent. [15] He has reported the use of wine for wound care in this surgery. Some reports of children surviving this surgery are available from the early medieval Islamic era. [16]
This neurological problem can also result in reduced sensation of rectal filling and weakness of the anal sphincter because of weak muscular contraction so can cause stool leakage. [12] In patients with multiple sclerosis, constipation and fecal incontinence often coexist, and they can be acute, chronic or intermittent due to the fluctuating ...
In cases where an episiotomy is indicated, a mediolateral incision may be preferable to a median (midline) incision, as the latter is associated with a higher risk of injury to the anal sphincter and the rectum. [15] Damage to the anal sphincter caused by episiotomy can result in fecal incontinence (loss of control over defecation). Conversely ...