1.   Basal pressures in the spinal group were similar to those in normal subjects but conscious control of sphincter activity was abolished in all spinal patients.

2.   In the spinal patients, the maximum distension volume was taken to be either when the patients experienced autonomic symptoms or when the balloon was expelled automatically.

3.   No differences were observed between male and female spinal patients for any of the variables tested in this study.

4.   The rise in anal pressure during the manoeuvre was much lower in spinal patients than in controls and varied according to the level of the spinal lesion.

5.   Internal anal sphincter relaxation increased in amplitude and duration in all spinal patients and normal controls as the rectum was distended intermittently with increasing volumes.

6.   Similarly, the duration of anal relaxation was greater at low distension volumes in spinal patients compared with controls.

7.   The external anal sphincter responses to intermittent rectal distension were noticeably attenuated in spinal patients compared with normal subjects.

8.   In all spinal patients the distension evoked uninhibited giant rectal contractions.

9.   This observation could explain why straining is often ineffective in promoting normal defecation even in low spinal patients with intact abdominal musculature.