Resting anal pressures

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USMLE Step 1 Preparation Secrets Study Guide: USMLE Exam Review for the United States Medical Licensing Examination Step 1Option B.

Resting anal pressures are largely a result of the myogenic tone of the internal anal sphincter which is not affected in patients with multiple sclerosis. Decreased pressures are seen in many diabetic patients (although not all) with fecal incontinence, presumably due to autonomic dysregulation. In systemic sclerosis, the IAS (internal anal sphincter) is frequently thin and fibrotic whereas lateral sphincterotomy surgically incises the IAS to reduce tone and allow anal fissures to heal.

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