What Is Anorectal Manometry?
During anorectal manometry, a small, flexible tube (called a catheter) 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 pressure. During the test, the small balloon attached to the catheter may be inflated in the rectum and muscle activity and sensation is tested. Anorectal manometry is not painful, however, you may experience slight discomfort.
Why Is Anorectal Manometry Done?
Anorectal Manometry for Fecal Incontinence
Fecal incontinence is the inability to control your bowel movements. Also called bowel or anal incontinence, this condition can range from occasional leakage to a complete loss of bowel control. The ability to hold stool (called continence) requires the rectum, anus, and nervous system to be working in sync at a normal rate. If you have normal continence, your external and internal anal sphincter muscles are able to hold the stool in place. Normal continence also gives your body the ability to store and relax stool. Fecal incontinence can be caused by weak anal sphincter muscles or poor sensation in the rectum, which can be evaluated with anal manometry. If these abnormalities are found upon testing, they can be treated. Biofeedback techniques and special exercises of the pelvic floor muscles can strengthen the muscles and improve sensation.
Anorectal Manometry for Constipation
Constipation occurs when bowel movements become difficult to pass or less frequent than normal. There are many causes of constipation, including inadequate fiber intake, dehydration, medication, or stress. Some people experiencing constipation may have sluggish colon movement, while for others, the anal sphincter muscles are to blame. In some patients with constipation, the anal sphincter muscles do not relax appropriately when bearing down to have a bowel movement. This abnormal muscle function may cause a functional type of obstruction. Muscles that do not relax with bearing down can be re-trained with biofeedback techniques using anal manometry.
How Should I Prepare For Anorectal Manometry?
To prepare for anorectal manometry, tell your doctor about any medications you’re taking and any medication allergies you may have. They will tell you whether or not you can continue to take your medication as usual before the examination. Ideally, the test is performed with an empty rectum. Most likely, you will be advised to take an enema at home before the procedure, but your doctor will give you more specific instructions. If you are instructed to use an enema, you may need to take one the night prior to the exam and 2 hours prior to the appointment.
What Can I Expect During Anorectal Manometry?
The test takes approximately 30 minutes. You will be asked to change into a hospital gown, and the nurse or technician will explain the procedure to you and answer any questions you may have. The patient then lies on their left side. The catheter, connected to a machine that measures pressure, is then inserted into the rectum and slowly withdrawn. 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 patient to squeeze, relax, and push at various times.
The anal sphincter muscle pressure is 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 as if trying to have a bowel movement. Two other tests may be done: first, an anal sphincter electromyography (EMG) to evaluate the nerve supply to the anal muscle, and second, measurement of the time it takes to expel a balloon from the rectum. After the examination, you may drive yourself home and go about your normal activities. You may experience some discomfort and mild bleeding for a couple of days after the exam. If you experience recurring discomfort and bleeding for three days, please call your doctor.
What Are The Possible Complications Of Anorectal Manometry?
Anorectal manometry is a safe, low-risk procedure and is unlikely to cause any pain.
Complications are rare, but it is possible for a perforation (tearing) or bleeding of the rectum to occur. Equipment failure is a remote possibility. If you are allergic to latex, you should inform the nurse before the test so that a latex-free balloon can be used.
Anorectal Manometry at Digestive Healthcare Center
At Digestive Healthcare Center, our physicians are experienced in performing anorectal manometry procedures to help patients discover the cause of their symptoms and find relief. We have three convenient locations across New Jersey, and we offer a variety of procedures focused on promoting positive digestive and gastroenterological health. To learn more about anal manometry or the conditions we treat, please contact us or request an appointment today.