Mechanisms of continence
There are number of mechanisms which maintain continence:
- sigmo-rectal 'sphincter':
- rectal contraction is a reflex response to filling
- contraction is inhibited cortically
- a temporary holdup of faeces at the acute angle of the pelvic loop of the sigmoid colon may aid continence
- ano-rectal angle:
- the pubo-rectalis sling maintains the acute angle between the rectum and the anus, preventing passage of the stool into the anal canal
- the pubo-rectalis sling maintains the acute angle between the rectum and the anus, preventing passage of the stool into the anal canal
- anal sphincters:
- external sphincter - striated muscle, voluntary
- internal sphincter - smooth muscle
- vascular cushions complete the seal
- ano-rectal sensation:
- the ability to distinguish flatus and stool is especially important in the presence of diarrhoea
Reference:
- Hayden DM, Weiss EG. Faecal incontinence: aetiology, evaluation, and treatment. Clin Colon Rectal Surg. 2011 Mar;24(1):64-70.
- Rao SS. Pathophysiology of adult facal incontinence. Gastroenterology. 2004 Jan;126(1 suppl 1):S14-22.
Create an account to add page annotations
Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.