A concept of the anatomy of the anal sphincter mechanism and the physiology of defecation

Diseases of the Colon and Rectum
A Shafik

Abstract

A review of the new concepts of the anatomy of the anal sphincter mechanism and the physiology of defecation is presented. The external sphincter is a triple-loop system; each loop can function as a separate sphincter through voluntary inhibition action and mechanical compression. Stress defecation resulting from internal sphincter damage is described. A new technique for repair of rectal incontinence is presented, which depends on inducing continence not only by mechanical compression, but also by voluntary inhibition. The mechanism of defecation and rectal continence is described and four types of incontinence presented. Also, the mechanism of both the levator dysfunction syndrome and prolapse is demonstrated and a technique of repair is presented. The study defines two types of rectal anomalies; suprahiatal and infrahiatal. The role of the embryonic anorectal sinus, anorectal band, and epithelial debris in the genesis of perirectal suppuration, chronic anal fissure, pruritus ani, and hemorrhoids is described. The communicating veins, identified between the hemorrhoidal and vesical plexuses, offer an explanation for the vague pathologic aspects of recurrent bacteriuria, urethral discharge, cervicitis, and vaginitis, and provi...Continue Reading

References

Apr 1, 1984·Journal of Clinical Gastroenterology·A Shafik

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Citations

Aug 1, 1994·Diseases of the Colon and Rectum·D LevienE Gross
Aug 17, 2006·Archives of Gynecology and Obstetrics·Ahmed ShafikAli A Shafik
Aug 6, 2008·Techniques in Coloproctology·A P ZbarM Pescatori
Sep 1, 2007·Diseases of the Colon and Rectum·Maolin Guo, Dawei Li
Aug 19, 2007·Diseases of the Colon and Rectum·Dawei Li, Maolin Guo
Jun 1, 1995·Paraplegia·A Shafik
Jan 1, 1989·Annals of Surgery·T J Yeatman, K I Bland
Dec 9, 2000·Current Opinion in Obstetrics & Gynecology·A Shafik
Sep 1, 1996·The Australian and New Zealand Journal of Surgery·N Bogduk
Sep 15, 2005·Anatomical Science International·Ahmed ShafikOlfat El-Sibai
Dec 17, 2008·Acta chirurgica Iugoslavica·Y A ShelyginO Yu Fomenko
Aug 11, 1998·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·A Shafik
Sep 13, 2006·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Ahmed ShafikAli A Shafik
Nov 1, 2007·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Ahmed ShafikOlfat El Sibai
Dec 30, 1998·Journal of Pediatric Surgery·A Montalvo-MarinM A Diaz-Lira
Nov 1, 1996·Journal of Pediatric Surgery·A Shafik
Nov 2, 2004·BMC Surgery·Jacques BecoMichèle Bex
Jul 1, 1994·The British Journal of Surgery·P B LoderR K Phillips
Oct 6, 2019·Pediatric Surgery International·Long LiWei Cheng
Mar 1, 1989·Gut·C A EdwardsN W Read
Jan 9, 2003·The Surgical Clinics of North America·Andreas M Kaiser, Adrian E Ortega

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