&NA;The physiologic status of the anorectum after low anterior resections or pull‐through operations of the rectum was evaluated clinically and by manometric studies. It was demonstrated that the presence of a normal anal resting pressure and an anorectal reflex were important to achieve postoperative continence after sphincter‐saving operations. In patients with anastomotic leaks and poor function, a marked high‐pressure zone in the anal canal and an anorectal reflex were not found, but as local inflammation resulting from the anastomotic leak disappeared, these parameters returned to normal. A normal anorectal reflex was found in one of three patients after Bacon‐type pull‐through operations, but the remaining two showed an increase of anal canal pressure during colonic distention. These results indicate that an elevation of anal‐canal pressure in response to colonic distention plays a significant role in fecal continence at the time of “a sense of urgency” if internal sphincter function is impaired.