Background—Topical nitrates lower anal sphincter pressure and heal anal fissures, but a majority of patients experience headache. The internal anal sphincter has a calcium dependent mechanism to maintain tone, and also receives an inhibitory extrinsic cholinergic innervation. It may therefore be possible to lower anal sphincter pressure using calcium channel blockers and cholinergic agonists wi...

BACKGROUND Topical nitrates lower anal sphincter pressure and heal anal fissures, but a majority of patients experience headache. The internal anal sphincter has a calcium dependent mechanism to maintain tone, and also receives an inhibitory extrinsic cholinergic innervation. It may therefore be possible to lower anal sphincter pressure using calcium channel blockers and cholinergic agonists wi...

treatment of patient with high anal fistulas has become complicated and post-operative complications are common. the aim of this study was to evaluate post-operative complications of primary sphincter’s repair technique in patients with high anal fistula. an interventional quasi-experimental study was conducted on 60 patients(42 male & 14 female) with high anal fistula. the most frequent age gr...

I. Anatomy TWo sphincters guard the anal canal, the external sphincter and the internal sphincter. The external sphincter.?The external .sphincter is composed of the subcutaneous part, the superficial part, and the profundus or the deep part. The subcutaneous part is composed of muscle fibres surrounding the anal orifice, and is intimately connected with the skin. It is supplied by perineal bra...

Botulinum toxin can chemically denervate striated muscle. Botulinum toxin A (15 U) was used to treat ten patients with chronic anal fissure by injection in the internal sphincter. In seven patients, the lesion healed at 2 months after treatment; one relapsed at 3 months. In one patient the lesion healed at 1 month, but partly relapsed a month later. Mild faecal incontinence lasting for 1 day wa...

hemorrhoidectomy is the treatment of choice for patients with third or fourth-degree hemorrhoids. although the majority of surgeons believe that surgical hemorrhoidectomy is the most effective approach with excellent results in the management of hemorrhoid disease, but hemorrhoidectomy is not a simple procedure. one of the complications of this surgery is an injury to anal sphincters that can l...

The aim of study is to investigate the development of the anal canal in human embryos and foetuses. In embryos at stage 19 the boundary between the ectodermal and endodermal linings of the anal canal is located just below the level of the internal anal sphincter muscle. Histological sections showed that the first signs of anal columns are observed in embryos at stage 21 (51 days).

In order to investigate the electrophysiology of the human internal anal sphincter and two current concepts of sphincter function, simultaneous manometric and electrical recordings were made from circular smooth muscle of the internal anal sphincter in the resting state and during reflexly induced sphincter relaxation. Three groups were studied: seven normal subjects, 25 patients with functiona...