Reference Work Entry

The ASCRS Textbook of Colon and Rectal Surgery

pp 33-39

Anal Physiology

  • Susan M. Parker
  • , John A. Coller


Normal bowel continence is a complex process that involves the coordinated interaction between multiple different neuronal pathways and the pelvic and perineal musculature. The importance of the anatomic relationships of the pelvic floor in maintaining normal continence has been suggested since the 1950s. Yet the complex series of neural and behavioral- mediated interactions, combined with a lack of an ideal study to take all elements into account, makes complete understanding of anorectal anatomy and physiology’s role in preserving continence difficult. Complicating this are multiple other factors that have a role in normal regulation such as systemic disease, emotional effects, bowel motility, stool consistency, evacuation efficiency, pelvic floor stability, and sphincter integrity.