Anorectal manomtery

The lower digestive system consists of the large intestine (caecum, ascending colon, transverse colon, descending colon, and sigmoid colon), rectum and anus. The rectum acts as a temporary storage area for feces -the waste product of the digestive system. The anal sphincter is the ring of muscles that control the opening and closing of the anus. Anorectal manometry measures the pressures of the anal sphincter muscles, the sensation in the rectum, and the neural reflexes that are needed for normal bowel movements as well as coordination of the rectal and anal muscles.

Who needs to undergo ano- rectal manometry testing?

Anorectal manometry is very effective in evaluating the contraction and coordination function of the rectum and anus in many situations like constipation, fecal incontinence. The test is also required in pouch surgery decisions.

Preparation

You should not eat or drink for two hours prior to the procedure. You will be given rectal enemas two hour prior to study to make rectum empty. You may take regular medications with small sips of water at least 2 hours prior to the study.

Procedure

The patient lies on his or her left side. A small, thin soft tube, about the size of a thermometer, with a balloon at the end is inserted into the rectum. The catheter is connected to a machine that measures the pressure. During the test, the small balloon attached to the catheter may be inflated in the rectum to assess the normal reflex pathways. The nurse or technician may also ask the person to squeeze, relax, and push at various times. The anal sphincter muscle pressures are measured during each of these maneuvers. To squeeze, the patient tightens the sphincter muscles as if trying to prevent anything from coming out. To push or bear down, the patient strains down as if trying to have a bowel movement. Other tests performed are Balloon Expulsion Test (to bear down and expel the inflated balloon in rectum) and EMG (to record the sphincter muscle activity) The procedure takes about 15 to 20 minutes from start to finish and you can resume regular activity immediately after the exam.

Side effects

Anorectal manometry is a safe, low risk procedure and is unlikely to cause any pain. Complications are very rare. If you are allergic to latex, you should inform the nurse/technician before the test so that a latex free balloon can be used

Alternative test/option

Other test to examine anorectal pressures and sphincter is MRI scan. But it requires skill and experience