Anorectal Manometry Testing for Problems with Bowel Movements
When your bowels are not eliminating properly, or you have issues with bowel incontinence, this can greatly impact your ability to live a normal life. Anorectal manometry testing is a quick, virtually painless procedure that can help pinpoint underlying issues with ongoing constipation or fecal incontinence.
What Is Anorectal Manometry Testing?
Anorectal manometry testing evaluates how the anal sphincter and rectum function together to eliminate feces from the lower digestive system. If you have issues with constipation or fecal incontinence, your doctor may recommend the test to determine potential underlying causes.
The anal sphincter is made up of two muscular valves that control fecal elimination once it collects in the lower part of the digestive tract. The rectum is where stool is held until defecation, and the anal sphincter controls anal opening and closing. However, certain issues may impede the sphincter and rectum from working together as they should, which affects bowel movements (BMs) and continence.
While constipation (fewer than three BMs per week) and fecal leakage are the most common reasons for anorectal manometry, the test may also be recommended to evaluate an individual with:
- Anal or rectal injuries or malformations that affect muscles, nerves, or sphincters
- Problems with anorectal muscle function due to prior rectal cancer treatment
- Issues related to irritable bowel syndrome, which is often characterized by constipation or diarrhea
- Suspected Hirschsprung’s disease, which is a condition children can be born with that affects bowel muscles
How Does the Anorectal Manometry Testing Work?
The anorectal manometry involves inserting a thin, flexible catheter with a small balloon attached to the end into the anal opening and rectum. The doctor inflates the balloon slowly after insertion and may move it to different points during the exam. This results in nerves in the anus and rectum responding, which should cause muscles to contract. The catheter is attached to a machine that captures how the anal sphincter and rectum respond and contract during the test.
How Do You Prepare for a Manometry?
Before anorectal manometry can be performed, your lower digestive tract does need to be empty. Therefore, before the test, you may need to:
- Avoid eating or drinking after midnight the night before the test
- Use a store-bought enema 2 or 3 hours before the test to empty your bowels
- Discuss if you should take prescribed medications before the exam with your doctor
What To Expect During the Anorectal Manometry Test
Anorectal manometry testing only takes about 15 minutes, and you are fully conscious throughout the procedure. The test itself is relatively simple and not painful, so there is no need for anesthesia. After undressing, you will be positioned on your side on the exam table. The steps involved from here will usually look something like this:
- A thin, flexible catheter (tube) with a built-in balloon on the tip is gently pushed into the anal opening, past the anal sphincter and into the rectum.
- The doctor uses an attached machine to slowly push air into the balloon at the end of the catheter to mimic what occurs when stool collects in the rectum.
- You may be asked to push, cough or squeeze periodically as the balloon is inflated, deflated, or changed in position; you may also be asked for feedback about the sensations you feel.
- The balloon may be moved to different areas. This process may be repeated a few times.
- Throughout the test, the catheter and balloon remain connected to a machine that records how your body responds.
- Once testing is finished, the balloon is fully deflated and removed.
What To Expect After the Test
Once the anorectal manometry test is complete, the doctor will go over the results with you. The information collected about how your lower digestive tract responded may help the care provider identify the causes of problems with incontinence or constipation.
For example, the test may show that anal sphincters are weak or slow to respond due to a lack of sensations. These issues could contribute to fecal incontinence. Likewise, the test may show that the muscles of the anal sphincter don’t relax as they should, which causes constipation. These types of issues can be treated with special exercises and biofeedback techniques that may improve muscle tone and sensations.
You are free to return home and resume your typical daily activities and dietary intake after the procedure.
If Dr. Coyle Finds Something During the Test, What Are My Treatment Options?
In the event anorectal manometry testing reveals an issue, Dr. Coyle may recommend:
- Changes in your diet
- Certain medications that can help with symptoms
- Muscle strengthening exercises to retrain muscles and nerves
- Surgical repair
If you have issues with constipation, fecal incontinence or other problems with bowel movements, you may be a good candidate for anorectal manometry. Reach out to schedule a consultation with Dr. Coyle at the Coyle Institute at 850-637-8258.