The anoderm, or anal skin, at the bottom of the anal canal contains numerous nerve endings and can cause severe pain if torn.
What is the anoderm?
The anoderm is part of the continence organ and is located in the lower part of the anal canal. Its thin skin is adjacent to the sphincter muscle, whose function it supports well. This is because with the help of its sensitive nerve endings, the anal mucosa can reliably sense the consistency of a bowel movement. In cooperation with the muscles in the anus, the anal cuticle helps control the movements of the sphincter muscle, depending on the consistency of the bowel contents.
Anatomy and structure
The thin cuticle in the anal region has a length of about 40 millimeters and shows a whitish-reddish coloration. An anoderm runs from the anus to the upper middle of the anal canal. In the upper part, the hairless cuticle consists of the so-called non-keratinized squamous epithelial cells. Where it is adjacent to the sphincter and comes into contact with air, these squamous cells are keratinized. The flat cells of the upper skin layer lie in several layers on top of each other and have particularly great stability and elasticity due to their tight interlocking. If it is keratinized, the top layer of the skin consists of dead epithelial cells containing keratin. The keratinization at the anus protects the skin primarily from external influences. The anoderm, or anal canal skin, is also firmly connected by nerve tracts to the anus, the ring-shaped smooth muscle at the anus. With the sphincter muscle at the anus, the anoderm coordinates bowel evacuation and can also distinguish between the consistencies of bowel movements.
Function and tasks
Because the anoderm is very thin and also has many nerve fibers, it is in many cases the cause of certain diseases in the proctological area. This is because the unkeratinized cuticle in the anal canal can easily tear and often become inflamed. In addition, the anal mucosa is characterized by a particularly strong sensitivity to pain. A common condition of the sensitive mucosa is anal fissure. This tear in the anal skin not only triggers pain during defecation, but also leads to other symptoms, such as burning and itching at the anus. Bright red blood in the stool or on the toilet paper is also often a sign of a tear in the anoderm. Causes diagnosed in most cases include digestive disorders, such as constipation or diarrhea. Enlarged hemorrhoids, which usually form near the anoderm, can also lead to an ulcer on the anal skin. Because they obstruct the inflow or outflow of blood in this area of the body, the tears in the anal mucosa caused by hemorrhoids may heal more poorly. People who suffer from Crohn’s disease or cryptitis – an inflammation of the rectum – also often get anal fissures as a consequence of their disease.
Diseases
Regardless of a person’s age, cracks in the anal skin can occur whenever it is subjected to too much stress. For example, bowel movements that are too hard or even frequent heavy squeezing increase the risks for anal fissures. Because a tear in the anal skin hurts a lot, those affected often tense their sphincter muscle, which leads to further problems during bowel movements. Tightness of the sphincter subsequently leads to poorer blood flow and thus slower healing of the anal fissure. A proctological examination can clarify for those affected exactly where the tear has occurred and how deep it runs. Acute fissures are treated by the specialist with special ointments or suppositories. To relieve the pain, most of the medications contain local anesthetic ingredients. In some cases, the doctor also injects an anesthetic directly under the resulting wound. This allows the patient to relax the sphincter muscle for a time. In the case of chronic skin tears, active ingredients that relax the sphincter muscle and at the same time promote its blood flow usually help. If scarring of the tissue or a so-called outpost fold, a marisk-like skin change at the rear end of the fissure, develops as a result of an anal fissure, this is a chronic inflammation. In these cases, the scarred tissue must be removed by the doctor through a surgical procedure. In case of pain in the anal area, it is advisable to consult a proctologist at an early stage for a consultation.Because only he can recognize whether enlarged hemorrhoids or another disease is the cause of the fissure. Because the sooner treatment is addressed, the faster a tear in the anoderm can be healed. To prevent or alleviate anal fissures and enlargement of hemorrhoids, a healthy diet, plenty of exercise and an adequate amount of daily beverages will help. At the same time, high-fiber meals with plenty of fruits, vegetables and whole grains ensure regulated digestion. Fiber not only stimulates bowel activity, but also keeps you full longer and prevents weight gain. To avoid hard stools, it also helps to drink about 1.5 liters of fluid a day. Water, unsweetened teas or juice spritzers are recommended. Daily exercise not only stimulates the metabolism, but also keeps the bowels on their toes. A daily round on the bike or a walk is already enough to maintain fitness and regulate the digestive system.
Typical and common anal diseases
- Anal discomfort (anal discomfort)
- Fecal incontinence
- Anal fissure (anal fissure)
- Anal fistula
- Anal itching (itching at the anus)
- Pain during defecation
