{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T23:46:32Z","timestamp":1791935192116,"version":"4.3.4"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,3,27]],"date-time":"2013-03-27T00:00:00Z","timestamp":1364342400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The patterns of impaired internal anal sphincter activity were studied in patients with anal fissure (<jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Twenty healthy controls and 61 patients with acute <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> were studied, using anorectal manometry with electromyography (EMG), and 53 patients with chronic <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> using high\u2010resolution manometry and ultrasonography. Mean and maximal resting anal pressure (MRAP), spontaneous rhythmic slow and ultraslow waves (USW) and relaxation induced by rectal distension were measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with acute <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> had higher mean (106.4\u00a0\u00b1\u00a028.1\u00a0mmHg) and maximal resting anal pressure (161.5\u00a0\u00b1\u00a043.7\u00a0mmHg) than those with chronic <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05); 95% of patients had slow waves (SW) and 67% ultraslow waves. Patients with chronic <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> had higher mean (92.4\u00a0\u00b1\u00a022.6\u00a0mmHg) and maximal resting anal pressure (117.5\u00a0\u00b1\u00a032.0\u00a0mmHg) than controls and 94% of patients had slow waves and 69% ultraslow waves. Patients with ultraslow waves (with either acute or chronic <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>) had increased internal sphincter hypertonicity (mean and maximal resting pressure), decreased internal sphincter relaxation and increased after\u2010contraction following rectal distension.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with acute <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> had higher hypertonicity than those with chronic <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> and both had increased spontaneous rhythmic activity (waves). Patients with <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> and ultraslow waves had higher internal anal sphincter hypertonicity and reduced internal sphincter relaxation and enhanced after\u2010contraction following rectal distension.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.12095","type":"journal-article","created":{"date-parts":[[2012,12,5]],"date-time":"2012-12-05T23:02:07Z","timestamp":1354748527000},"page":"492-499","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Patterns of impaired internal anal sphincter activity in patients with anal fissure"],"prefix":"10.1111","volume":"15","author":[{"given":"A.","family":"Opazo","sequence":"first","affiliation":[{"name":"Department of Surgery Hospital de Matar\u00f3 Barcelona Spain"},{"name":"Universidad Santo Tom\u00e1s Concepci\u00f3n Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Aguirre","sequence":"additional","affiliation":[{"name":"Department of Surgery Hospital de Matar\u00f3 Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Salda\u00f1a","sequence":"additional","affiliation":[{"name":"Department of Coloproctology Cl\u00ednica Sagrada Familia Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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