Name of the Procedure:

Anorectal Manometry

Summary

Anorectal manometry is a diagnostic test used to evaluate the function of the muscles in the rectum and anus. It helps to diagnose conditions related to the bowel control and defecation.

Purpose

Anorectal manometry addresses issues with bowel control and defecation. The goals of the procedure include understanding the strength and coordination of rectal and anal muscles and identifying potential nerve damage or structural abnormalities.

Indications

• Chronic constipation
• Fecal incontinence
• Unexplained rectal pain
• Difficulties in bowel movements

Preparation

Patients are generally asked to:

• Follow a clear liquid diet for 24 hours before the procedure.
• Avoid eating or drinking anything after midnight on the day of the test.
• Undergo a bowel cleanse, usually with an enema or a laxative, as instructed by the healthcare provider.

Procedure Description

1. The patient is asked to lie on their side.
2. A thin, flexible tube called a catheter is gently inserted through the anus into the rectum.
3. The catheter has sensors that measure muscle pressure and activity.
4. The patient may be asked to perform certain actions, such as squeezing, relaxing, and pushing, to assess muscle function.
5. The catheter is connected to a machine that records the pressure and muscle function data.

No sedation is typically needed, but a local anesthetic gel may be applied for comfort.

Duration

The procedure usually takes about 30 to 60 minutes.

Setting

Anorectal manometry is performed in a hospital, outpatient clinic, or specialized diagnostic center.

Personnel

• Gastroenterologist or specialized nurse
• Medical assistant or technician

Risks and Complications

• Mild discomfort or pressure during the procedure
• Rarely, minor bleeding or infection at the insertion site

Complications are rare and typically manageable with simple interventions.

Benefits

• Provides crucial information for diagnosing bowel disorders
• Helps guide effective treatment plans
• Typically, benefits are realized shortly after the diagnosis is confirmed and appropriate treatment initiated.

Recovery

• Patients typically resume normal activities immediately after the procedure.
• Mild discomfort may persist briefly but usually resolves quickly.
• Follow-up appointments may be scheduled to discuss results and treatment options.

Alternatives

• Defecography: Imaging to visualize the rectum during bowel movement.
• Colonic transit studies: Track the movement of food through the colon.
• Endoanal ultrasound: Imaging to assess structural abnormalities.

Each alternative has its own pros and cons, including differences in the information provided and the invasiveness of the procedures.

Patient Experience

Patients might experience mild discomfort or pressure during the insertion and measurement process but are typically able to tolerate the procedure well. Pain management typically involves the application of a local anesthetic gel, and post-procedure discomfort is usually minimal.