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The human body has over 50 types of sphincter muscles, which are circular muscles that open and close bodily passages to regulate the flow of substances such as bile, urine, and faeces. One of the most important sphincter muscles is the sphincter pylori, which holds food in the stomach until it is thoroughly mixed with gastric juices. Dysfunction of the urethral sphincter can lead to urinary incontinence, while a malfunction of the anal sphincter can cause faecal incontinence. Pelvic muscle retraining and exercises can help strengthen the sphincter muscles and improve bowel control.
How to improve sphincter muscles
| Characteristics | Values |
|---|---|
| Pelvic muscle retraining | Helps individuals achieve better control of the pelvic floor muscles |
| Surgery | May not be helpful if the pudendal nerve is damaged on both sides |
| Exercises | Squeeze the muscles as hard as you can, then relax. Repeat this up to 10 times, 3 times a day |
| Stool softeners and fibre | Can be used to treat overflow incontinence |
| Rectal sensation training | Teaches the person to recognise smaller rectal volumes |
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What You'll Learn
Pelvic floor muscle retraining exercises
The first step in performing pelvic floor muscle exercises is to identify the correct muscles. One way to do this is to try to stop the flow of urine midway through emptying your bladder. This is only a method to identify the muscles and should not be done regularly. Another way to identify the correct muscles is to insert a finger into your vagina or rectum (depending on your gender) and tighten the muscles as if you are holding in your urine.
Once you have identified the correct muscles, you can begin performing the exercises. One basic exercise involves tightening the pelvic floor muscles and holding for a count of 10, then relaxing the muscles completely for a count of 10. Repeat this 10 times, 3-5 times a day. These exercises can be done at any time and place, either lying down or sitting in a chair.
There are also other exercises that can help relax and condition the pelvic floor muscles, such as quick flick Kegels, marches, heel slides, and the Happy Baby Pose. Quick flick Kegels involve quick contractions of the pelvic floor muscles to help activate them faster and stronger. Heel slides target both the pelvic floor and deep abdominal muscles. For the Happy Baby Pose, lie on the floor with your knees bent and bring your knees toward your belly at a 90-degree angle. Then, grab your feet and open your knees wider than your torso before bringing your feet up toward your armpits.
It is important to note that pelvic floor muscle exercises should be done correctly to avoid any discomfort or negative effects. Make sure to keep the muscles above the belly button relaxed and only tighten the pelvic floor muscles. If you are unsure or experiencing any issues, consult a healthcare professional.
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Anal sphincter anatomy
The anal sphincter muscles are located at the lower part of the rectum, which is about 4.7 inches long in adults. The internal anal sphincter is located inside the rectum and the external anal sphincter is located around the outside of the end of the anal canal. The internal anal sphincter is a smooth muscle, about 30mm in height and 3mm in thickness, and originates from extensions of the circular layers of the rectum into the anal canal. The external anal sphincter, on the other hand, is a skeletal muscle made up of striated fibres and has a more complex morphology. It is composed of three parts that loop around the anal canal: the upper or deep part, the middle or superficial part, and the lower or subcutaneous part.
The internal and external anal sphincters work together to produce a bowel movement, but in different ways. The internal anal sphincter is involuntary in action, regulated by the autonomic nervous system. When stool moves through the digestive tract, it triggers the internal anal sphincter to relax through the rectoanal inhibitory reflex (RAIR), which is a reflexive relaxation in response to rectal distension. This relaxation, in turn, triggers the external anal sphincter to contract through the defecation reflex. The external anal sphincter is a voluntary muscle, responding to commands to contract and maintain continence when faeces are propelled into the rectum. It keeps the orifice of the anal canal closed and relaxes upon defecation.
Several diseases, conditions, and injuries can affect the anal sphincter. For example, anal stenosis, a rare condition where the internal anal sphincter becomes narrowed, making bowel movements difficult. It can be caused by surgery, especially hemorrhoid removal, or be associated with laxative overuse or infections. Anismus is another condition that affects the external anal sphincter, causing problems with the way the muscle contracts and relaxes during defecation. Fecal incontinence, which is the involuntary passage of liquid or solid stool, can occur when there is a loss of muscle control in the sphincter muscles. It can be caused by various factors, including bowel disorders, trauma to the anal sphincter, chronic diseases, neurological disorders, and inflammatory bowel disease.
The anal canal, which includes the anal sphincter, is the terminal part of the gastrointestinal tract, conveying material from the rectum to the anus. It plays a crucial role in differentiating between solid, liquid, and gas, contributing to fecal continence, and acting as a defence against organisms that might enter the body.
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Voluntary vs involuntary sphincters
A sphincter is a circular muscle that maintains constriction of a natural body passage or orifice and relaxes as required by normal physiological functioning. There are over 60 types of sphincters in the human body, some of which are microscopic. Sphincters can be classified as functional or anatomical, and they can also be categorised as either voluntary or involuntary.
Voluntary sphincters are supplied by somatic nerves and can be controlled consciously. An example of a voluntary sphincter is the external urethral sphincter, which controls the voluntary flow of urine from the bladder to the urethra. This sphincter is primarily made of skeletal muscle and is controlled by the deep perineal branch of the pudendal nerve and nicotinic receptors. The urethral sphincter is an integral part of maintaining urinary continence, and damage to this muscle can lead to urinary incontinence.
In contrast, involuntary sphincters are stimulated by autonomic nerves and function unconsciously. An example of an involuntary sphincter is the internal urethral sphincter, which controls the involuntary flow of urine from the bladder to the urethra. This sphincter is composed of smooth muscle and is controlled by the autonomic nervous system via the hypogastric nerves and alpha-one receptors. It is the primary muscle for prohibiting urination and is essential for maintaining urinary continence.
Another example of an involuntary sphincter is the internal anal sphincter, which is one of two sphincters that control the exit of faeces from the body. The internal anal sphincter is involuntary, while the external anal sphincter is voluntary. Involuntary sphincters, such as the internal urethral and anal sphincters, are essential for maintaining continence and preventing the release of urine or faeces.
While sphincters can be classified as either voluntary or involuntary, it is important to note that some sphincters, such as the urethral sphincter, are considered a single continuous layer with functionally independent areas. This highlights the complex nature of sphincter muscles and their role in maintaining normal physiological functioning.
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How to squeeze and relax the sphincter muscles
The sphincter muscles are circular muscles that maintain constriction of a natural body passage or orifice and relax as required by normal physiological functioning. There are over 60 types of sphincter muscles in the human body, some of which are microscopically small. The anal sphincter, for example, surrounds the entrance of the anus and can be voluntarily controlled.
Squeezing the sphincter muscles
- Spread your legs slightly apart.
- Consciously squeeze your anus and pelvic floor muscles as if you were trying to stop urinating mid-stream.
- Hold for three seconds and then gently release.
- Repeat this process up to 10-15 times.
Relaxing the sphincter muscles
- Practice deep breathing while focusing on your sphincter muscles.
- Breathe in slowly and deeply for about 4 seconds, then exhale slowly for another 4 seconds.
- As you do this, concentrate on how your sphincter muscles feel and allow them to relax.
- Repeat this process as many times as necessary.
- To locate your sphincter muscles, pretend you're trying to prevent yourself from passing wind or trying to hold in a bowel movement.
- You can also try meditating in a seated position with your eyes closed, taking slow, deep breaths through your nose.
- Massage your lower stomach with your fingers.
- Prop your feet up in a seated position to help relax your pelvic and sphincter muscles.
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Treatment options for faecal incontinence
Treatment for faecal incontinence depends on its cause, and can include dietary changes, exercises, medication, and surgery. Faecal incontinence, or bowel incontinence, occurs when an individual has trouble managing or controlling their bowel movements.
Dietary Changes
Changing one's diet can help prevent or relieve faecal incontinence. Doctors may recommend avoiding foods and drinks that aggravate diarrhoea. They may also suggest keeping a food diary to identify which foods and drinks affect faecal incontinence. Incorporating dietary changes can help reduce the risk of constipation.
Exercises
Biofeedback therapy uses devices to help individuals learn and perform exercises to strengthen their pelvic floor muscles. This therapy can also help patients learn to sense when stool is filling their rectum, and to control strong sensations of urgency. Biofeedback therapy is considered more effective than attempting pelvic floor exercises independently.
Medications
Over-the-counter medicines can help prevent diarrhoea.
Surgery
Surgery may be an option for faecal incontinence that does not improve with other treatments, or for incontinence caused by injuries to the pelvic floor muscles or anal sphincters. Sphincteroplasty, the most common surgery for faecal incontinence, reconnects the separated ends of an anal sphincter torn by childbirth or another injury. In cases where other treatment options have been exhausted, a colostomy may be performed, wherein an opening is created in the abdomen, and stools are collected in a bag attached to the abdomen.
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Frequently asked questions
Sphincters are circular muscles that open and close passages in the body to regulate the flow of substances such as bile, urine, and faeces. There are over 50 types of sphincters in the human body, some of which function involuntarily, some respond to stimuli, and others are controlled voluntarily.
Weak sphincter muscles can be caused by childbirth or increasing age. This can lead to faecal incontinence, which is the release of rectal contents against one's wishes.
Pelvic muscle retraining can help strengthen sphincter muscles. This involves exercises that target the pelvic floor muscles, such as squeezing and relaxing the muscles.
Strengthening the sphincter muscles can help improve bowel control, treat constipation, and reduce rectal or pelvic pain. It can also help restore independence and dignity to those affected by faecal incontinence.
