الفهرس 
Ano-Rectal AnatomyOnly 14 pages are availabe for public view
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Abstract
The term of haemorrhoids usually identifies signs and symptoms following distal displacement of anal cushions caused by fragmentation and degenerative changes in the submucosal tissue of the anal canal. They affect millions of people around the world, and represent a major medical and socio-economic problem (2).
Increased internal and external anal sphincter pressure may also be involved in haemorrhoid symptoms. The role of raised anal canal pressure in the pathophysiology of hemorrhoids has been the subject of several studies (5).
Many have wondered whether this increase in resting pressure is the cause or the result of pathological haemorrhoids. In fact, an increased anal tone is detectable in patients with internal hemorrhoids and is less evident in those with only external piles, and this tone decreases after standard excisional hemorrhoidectomy, so increased anal pressure is considered the effect rather than the cause of symptomatic hemorrhoids (73).
The techniques for ano-rectal manometry have evolved greatly over the years. Such testing has progressed from balloons or water sacs to water perfusion and most recently micro-transducers. Manometry measures the pressures within the anal canal and distal rectum that provides information about the function of the internal and external anal sphincters. This test is mainly performed to evaluate patients with constipation or fecal incontinence but is also useful for pre/post-surgical evaluation of anal sphincter tone (57).
The aim of this randomized prospective study was to monitor the relationship between haemorrhoids (grades and severity) and anal manometric findings before and after haemorrhoidectomy. There was statistically significant decrease in the mean resting pressure among cases pre-operative than post-operative and no difference between various degrees of severity regarding to manometrical results (resting anal pressure) pre-oparative and post-operative (resting anal pressure).
We concluded from this study that abnormally high pressures in the anal canal are common in patients with haemorrhiods and reduced by routine haemorrhoidectomy in all degrees of severity of the disease.