Hot or cold in anal pain?

A study of the changes in internal anal sphincter pressure profiles

Abstract

In 26 volunteers without anorectal complaints, and in 31 patients with anorectal problems such as hemorrhoidal disease, anal fissure, and proctalgia fugax, baseline resting anal canal pressures were recorded manometrically for 5 minutes at room temperature (23° C). In 16 volunteers (Group A) and 21 patients (group B) anorectal manometry was then performed while the anus was immersed in water at varying temperatures (5° C, 23° C, and 40° C). In ten volunteers (Group A′) and ten patients (Group B′) resting pressures were recorded for an additional 30 minutes following immersion for 5 minutes at 40° C. In all subjects (at leastP<0.01), resting anal canal pressures diminished significantly from baseline after immersion at 40° C, but remained unchanged in all subjects after immersion at 5° C and 23° C. In Group A′, anal canal pressures remained significantly reduced for 15 minutes (P<0.02). In Group B′, significant reduction in resting pressure lasted 30 minutes (P<0.02). Wet heat applied to the anal sphincter apparatus significantly and reproducibly decreased resting anal canal pressures over time, and therefore was likely to benefit patients after anorectal operations and those with anorectal pain.

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References

  1. 1.

    Eisenhammer S. The surgical correction of chronic internal anal (sphincteric) contracture. S Afr Med J 1951;25:486–93.

    PubMed  CAS  Google Scholar 

  2. 2.

    Eisenhammer S. The evaluation of the internal anal sphincterotomy operation with special reference to anal fissure. Surg Gynecol Obstet 1959;109:583–90.

    PubMed  CAS  Google Scholar 

  3. 3.

    Eisenhammer S. Internal anal sphincterotomy plus free dilatation versus anal stretch with special criticism of the anal stretch procedure for hemorrhoids: the recommended modern approach to hemorrhoid treatment. Dis Colon Rectum 1974;17:493–522.

    PubMed  CAS  Google Scholar 

  4. 4.

    Colombo I. Terapia fisica e riabilitazione. Vol. 1. Milano, Italy: Wassermann, 1972:11.

    Google Scholar 

  5. 5.

    Weidenbacker RA, Smith C. Does heat cause relaxation? Phys Ther Rev 1960;40:261–5.

    PubMed  CAS  Google Scholar 

  6. 6.

    Basset SW, Lake BM. Use of cold applications in the management of spasticity. Phys Ther Rev 1958;38:333–4.

    Google Scholar 

  7. 7.

    Margaria R, DeCaro L. Principi di fisiologia umana. Vol. 2. Milano, Italy: Vallardi, 1972:1181.

    Google Scholar 

  8. 8.

    Duthie HL, Watts JM. Contribution of the external anal sphincter to the pressure zone in the anal canal. Gut 1965;6:64–8.

    PubMed  CAS  Google Scholar 

Download references

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Correspondence to Dr. G. Dodi M.D..

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Dodi, G., Bogoni, F., Infantino, A. et al. Hot or cold in anal pain?. Dis Colon Rectum 29, 248–251 (1986). https://doi.org/10.1007/BF02553028

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Key words

  • Manometry
  • Anorectum
  • Anal sphincters
  • Thermal