 Internal anal sphincter

The internal anal sphincter is a ring of smooth muscle at the lower end of the rectum and around the upper anal canal. It contributes involuntary resting closure. The surrounding external anal sphincter is a different muscle system with voluntary control, so the two should not be treated as one anatomical ring.^[ref]

Rectal distension can trigger relaxation of the internal anal sphincter, the rectoanal inhibitory reflex. Researchers can inflate a rectal balloon while recording anal pressure, separating this relaxation from other contractile responses and from reported sensation. A study of 23 subjects observed inhibitory and contractile reflexes during graded balloon distension.^[ref] A continuous pressure trace therefore reveals coordinated components of continence that are difficult to infer from static anatomy alone.