Faecal incontinence and functional constipation

There are grossly four elements to help control faecal continence: 1. Plug function Internal anal sphincter (IAS) plays a major role in acting as a plug at the final end of our gastrointestinal tract. It is innervated by our autonomous nervous system. External anal sphincter (EAS), puborectalis sling plus other pelvic floor muscle and haemorrhoidal cushings at anal canal also contribute. 2. Stool consistency The looser the stool, the more difficult we can prevent incontinence 3. Rectal capacity Rectum acts as temporary store for stool before we can choose a convenient place to evacuate. That means its volume and compliance are directly related our continence function. 4. Neurological function Central nervous system (brain and spinal cord) is definitely the higher centre to control. We can also control voluntary muscle like EAS through peripheral (somatic) nervous system. In the same time, autonomous nervous system receives sensation from rectum (distension) and anal canal (stretching) on one hand, it controls involuntary muscle like IAS on the other hand.