Anal Hypertonia
INTRODUCTION
Anal hypertonia/ anal hypertension is a common condition yet not much is said about it as a disease entity in itself. A rise in anal canal pressure may result from a disease in the anal canal, be the primary cause of disease in the anal canal or may exist lone (idiopathic).
WHO IS AFFECTED BY ANAL CANAL HYPERTONIA?
Males have a higher anal canal pressure than females. The prevalence of anal canal hypertonia begins to rise from age 30 year onwards, affecting males more than females. It is also prevalent in people who suffer from haemorrhoids, anal fissure, anal fistula, proctitis and other inflammatory diseases around the anus.
WHAT ARE THE SYMPTOMS OF ANAL HYPERTONIA?
- Anal hypertonia causes ischaemia to the tissues of the anus and cause anal pain or discomfort that is worse after passing stools and not relieved by analgesics.
- Anal hypertonia in anal fissures cause severe pain after moving the bowel that persist for a long time afterwards.
- Anal hypertonia associated with haemorrhoids worsen the symptoms of haemorrhoids, namely, anal discharge, burning sensation/pain in the anus, and complications of thrombosis, strangulation and gangrene of the hhaemorrhoids.
WHAT DISEASES ARE COMMONLY ASSOCAITED WITH ANAL HYPERTONIA?
- This is not associated with any disease of the anal canal and hence least known about.
- Anal fissure
- Haemorrhoids
- Anal fistula
- Proctitis
HOW IS ANAL CANAL HYPERTONIA INVESTIGATED?
- Proctoscopy
- Sigmoidoscopy or colonoscopy
- Anal manometry
- Squeeze and non-squeeze anal sphincter tone during digital rectal examination
- Pudendal nerve terminal motor latency
HOW IS ANAL HYPERTONIA TREATED?
- For idiopathic anal hypertonia the use of topic agents that relax smooths can be used but surgical intervention gives excellent results
- Anal hypertonia associated with anal diseases are also treated non-operatively, but best is surgery performed in tandem with surgery for the disease.
Prof Jonathan CB Dakubo