Anorectal manometry

Anorectal Manometry

Anorectal manometry is a diagnostic procedure that evaluates the function of the muscles in the rectum and anus. This test is crucial for individuals experiencing symptoms such as chronic constipation, fecal incontinence, or other anorectal disorders. The procedure involves measuring the pressures of the anal sphincter muscles, the sensation in the rectum, and the neural reflexes that are necessary for normal bowel movements.

Procedure

The anorectal manometry procedure involves the insertion of a thin, flexible tube, equipped with a sensor, into the rectum. The sensor measures the pressures exerted by the internal and external anal sphincters. During the test, patients may be asked to perform various actions such as squeezing, holding, and pushing, to assess the function of the anorectal muscles and nerves. The procedure typically lasts about 20 to 30 minutes and is usually performed on an outpatient basis.

Indications

Anorectal manometry is indicated for patients experiencing:

• Chronic constipation: Difficulty in passing stools over a long period.
• Fecal incontinence: Inability to control bowel movements, leading to unintentional loss of stool.
• Anismus: A condition where there is a failure of the anal sphincter muscles to relax during defecation.
• Rectal prolapse: A condition where the rectal walls have prolapsed and can be seen outside the body.
• Pre and post-surgical evaluations: Assessing the anorectal function before and after surgical interventions for conditions like rectal cancer.

Results Interpretation

The results from anorectal manometry can provide valuable information about the muscle tone and strength of the anal sphincters, coordination of rectal and anal muscles during defecation, and the sensitivity and function of the rectum. Abnormal results may indicate issues such as weak sphincter muscles, poor coordination between the rectum and anus, or reduced sensation in the rectum, which could contribute to anorectal dysfunction.

Risks and Complications

Anorectal manometry is generally considered a safe procedure with minimal risks. However, potential complications, although rare, can include:

• Discomfort or pain during the procedure.
• Minor bleeding, especially if there is an existing anal fissure or hemorrhoid.
• Risk of infection, although this is extremely rare.

Follow-up

Based on the results of anorectal manometry, further diagnostic tests or treatments may be recommended. Treatment options may include dietary changes, pelvic floor physical therapy, biofeedback, or surgery, depending on the underlying condition and severity of symptoms.

Conclusion

Anorectal manometry is a valuable diagnostic tool in the assessment of anorectal function. It provides essential information that can guide the management and treatment of various anorectal disorders, improving the quality of life for affected individuals.