Fecal incontinence induced by spontaneous internal anal sphincter relaxation: report of a case.

Abstract

It has been previously suggested that an increase in the frequency of internal anal sphincter relaxations may cause fecal incontinence in patients in whom a structural lesion of the anal sphincter or its nerve supply is not ruled out. We here report a case of fecal incontinence in which the sphincter and its innervation was not damaged, and prolonged recordings of anal resting pressure detected frequent and prolonged internal anal sphincter relaxations. Moreover, a spontaneous improvement in fecal incontinence occurred at the same time as a reduction in the frequency and duration of internal anal sphincter relaxations. This case suggests that prolonged recordings of anal resting pressure are advisable in incontinent patients without detectable lesions of the anal sphincter or its nerve supply to detect any increase in the frequency of internal anal sphincter relaxations as a possible cause of fecal incontinence.