Diseases of the Colon & Rectum

, Volume 38, Issue 4, pp 407–410 | Cite as

Abnormal internal anal sphincter fibrosis and elasticity in fecal incontinence

  • Christopher T. M. Speakman
  • Charles H. V. Hoyle
  • Michael A. Kamm
  • Michael Swash
  • Michael M. Henry
  • R. John Nicholls
  • Geoffrey Burnstock
Original Contributions
  • 16 Downloads

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 thein vitrolength-tension relationship of the freshly excised internal anal sphincter. RESULTS: Incontinent patients had a significantly higher collagen content than controls (55 percentvs.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.

Key words

Internal anal sphincter Fibrosis Neurogenic Fecal Incontinence 

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Copyright information

© American Society of Colon and Rectal Surgeons 1995

Authors and Affiliations

  • Christopher T. M. Speakman
    • 1
  • Charles H. V. Hoyle
    • 2
  • Michael A. Kamm
    • 1
  • Michael Swash
    • 1
  • Michael M. Henry
    • 1
  • R. John Nicholls
    • 1
  • Geoffrey Burnstock
    • 2
  1. 1.Sir Alan Parks Physiology UnitSt Mark's HospitalLondonUK
  2. 2.Department of Anatomy and Developmental Biology and Centre for NeuroscienceUniversity College LondonLondonUK

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