Diabetes and Bowel Habits

To the Editor: Investigating several aspects of anal-sphincter function, Schiller et al. (Dec. 30 issue)¹ stated that incontinence in diabetic patients was due to dysfunction of the internal anal sphincter. This conclusion was based largely on the assumption that basal sphincter pressure is produced for the most part by the internal sphincter. However, several findings indicate that the tonic contraction of the external sphincter contributes to the anal closure at rest. On the basis of measurements of the anal pressure in subjects with the somatic sphincter paralyzed, a contribution of 15 to 45 per cent has been suggested, depending on.