Abstract
PURPOSE: We aimed to investigate the changes in the proportion of collagen and in the elasticity of the internal anal sphincter in patients with neurogenic fecal incontinence. METHODS: Collagen content was studied in ten patients with neurogenic fecal incontinence (mean age, 51.5 years) and ten controls (age, 58.6 years) using histologic techniques to determine differences between incontinence and health and to determine the effect of aging. Changes in elasticity were also measured in 8 controls (mean age, 63 years) and 13 patients with neurogenic incontinence (mean age, 60 years) by recording the in vitro length-tension relationship of the freshly excised internal anal sphincter. RESULTS: Incontinent patients had a significantly higher collagen content than controls (55 percent vs.33 percent;P=0.013). In incontinent patients the amount of collagen and the patients' ages correlated significantly (P=0.001). There was a greater increase in stable tension per increase in muscle length in the strips from incontinent patients compared with controls. CONCLUSIONS: Changes in fibrous tissue content are likely to influence muscle tone and responsiveness of the sphincter in fecal incontinence.
Similar content being viewed by others
References
Swash M, Gray A, Lubowski DZ, Nicholls RJ. Ultrastructural changes in internal anal sphincter in neurogenic faecal incontinence. Gut 1988;29:1692–8.
Lubowski DZ, Nicholls RJ, Burleigh DE, Swash M. Internal anal sphincter in neurogenic faecal incontinence. Gastroenterology 1988;95:997–1002.
Klosterhalfen B, Offner F, Topf N, Vogel P, Mittermayer C. Sclerosis of the internal anal sphincter—a process of aging. Dis Colon Rectum 1990;33:606–9.
Williams MA. Quantitative methods in biology. In: Glauert AM, ed. Practical methods in electron microscopy. Amsterdam: North-Holland Biomedical Press, 1977;6:33–7.
Gibbons CP, Bannister JJ, Towbridge EA, Read NW. An analysis of anal sphincter pressure and anal canal compliance in normal subjects. Int J Colorectal Dis 1986;1:231–7.
Rasmussen O, Colstrup H, Lose G, Christiansen J. A technique for the dynamic assessment of anal sphincter function. Int J Colorectal Dis 1990;5:135–41.
Bannister JJ, Abouzekry L, Read NW. Effect of aging on anorectal function. Gut 1987;28:353–7.
Gilpin SA, Gilpin CJ, Dixon JS, Gosling JA, Kirby RS. The effect of age on the autonomic innervation of the urinary bladder. Br J Urol 1986;58:378–81.
Author information
Authors and Affiliations
Additional information
C. T. M. Speakman was supported by the Sir Alan Parks Research Foundation, The Royal College of Surgeons, and M. A. Kamm was supported by the St. Mark's Research Foundation.
About this article
Cite this article
Speakman, C.T.M., Hoyle, C.H.V., Kamm, M.A. et al. Abnormal internal anal sphincter fibrosis and elasticity in fecal incontinence. Dis Colon Rectum 38, 407–410 (1995). https://doi.org/10.1007/BF02054231
Issue Date:
DOI: https://doi.org/10.1007/BF02054231