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Anal stenosis anal stenosis is not a common condition, but it can be related to inflammatory bowel disease (ibd), and in crohns disease more so than in ulcerative colitis. In anal stenosis, the anal sphincter becomes narrowed, to the point where it is difficult to have a bowel movement. These muscles that control your bowel can be strengthened through exercise. While the internal anal sphincter is not under conscious control,. The external anal sphincter (or sphincter ani externus ) is a flat plane of skeletal muscle fibers, elliptical in shape and intimately adherent to the skin surrounding the margin of the anus. Though resting sphincter tone is predominantly attributed to the internal anal sphincter, studies under general anesthesia or after pudendal nerve block suggest the external anal sphincter generally accounts for approximately 25, and up to 50, of resting anal tone. 9, 33, 40, 50, 144, 170 when continence is threatened, the external sphincter contracts to augment anal tone, preserving continence. What causes anal sphincter muscle damage? Childbirth is the most common cause of damage in women. The incidence of anal incontinence following recognized obstetric anal sphincter injury is estimated at over 60. 63-year-old nancy experienced a fourth-degree perineal tear, expanding from the vagina to the rectum. Fecal incontinence occurs most commonly because the anal sphincter is not functioning properly. Damage to the sphincter muscles or to the nerves controlling these muscles, decreased muscle strength, excessively strong bowel contractions, or alterations to bowel sensation can all lead to this disturbance of function. Anal manometry uses pressure sensors and a balloon that can be inflated in the rectum to check the sensitivity and function of the rectum. Anal manometry also checks the tightness of the anal sphincter muscles around the anus. To prepare for this test, the person should use an enema and not eat anything 2 hours before the test.