General Supportive Measures

Abstract

The anal sphincters are dependent on several factors for optimal function. They must be able to respond to stimuli from the rectum, (and in particular to rectal distention) by alterations in tone (e.g. the recto-anal reflex); they must respond to gas, liquid and solid signals mediated by anal sampling with an appropriate response; they must be able to maintain “watertight” closure by a constant plateau of anal tone, reinforced by a voluntary contraction when needed; they must be able to participate by suitable relaxation-contraction responses in the neuromuscular mechanisms of defaecation, and these responses must be properly coordinated. When the sphincters are damaged, these subtle and delicate functions are likely to suffer, and sphincteric responses may never return to complete normality.