ANORECTAL MANOMETRY AND ANORECTAL FUNCTION TESTS
ANORECTAL MANOMETRY AND ANORECTAL FUNCTION TESTS - WHAT IS THE PURPOSE OF THIS DOCUMENT?
Before the procedure, we want to provide you with information about the examination you will undergo, any possible interventions, and the related risks. The information is intended to alleviate any justifiable concerns and misapprehensions you may have.
WHAT ARE ANORECTAL MANOMETRY AND ANORECTAL FUNCTION TESTS ?
Anorectal manometry is part of medical functional investigations and, as such, are at the crossroads between clinical interventions and therapy. These investigations help understand disorders affecting the passing of stool (faecal incontinence, constipation, pain). These tests include measuring the strength of anal muscles and an examination of the sensory function of the perineum). In the context of anal incontinence, important pressure values are anal pressure at rest, pressure values obtained during voluntary contraction, the duration of the voluntary contraction, the length of the anal canal, anorectal inhibiting and contracting reflexes, the need perception threshold, and the maximum tolerable volume during rectal distension. In the context of constipation, the pressure parameters that inform the treatment of the patient are anal pressure at rest and the stability of the curve at rest over an extended period of time, the rectoanal inhibitory reflex, pressures obtained at the level of the rectum and in the lower section of the anal canal during simulated defecation, and finally the volumes of perceived need and the maximum volume. The purpose of this examination is to obtain objective elements relating to the anorectal function. The intervention therefore aims at recording pressure values: at the level of the rectum and of the anal canal. These pressure values can be recorded without any stimulation when the patient is at rest, relaxed, and calm, or during voluntary stimulations such as pushing or withholding efforts, or during involuntary stimulations with the inflation of an intrarectal balloon. The tests last approximately 30 minutes. They are performed by a doctor who specialises in these techniques, with the assistance of a specialised nurse, and are conducted with the utmost respect for your dignity and intimacy.
HOW DO YOU PREPARE FOR ANORECTAL MANOMETRY?
You are asked to undergo a cleansing enema with two bottles of Cleen/Normacol or another form of enema approximately two hours before your examination. Gently introduce the enema nozzle, and inject the product over the course of two or three minutes, tighten your cheeks to keep the enema for at least 10 minutes, and, if possible, remain in a reclined position on your left side. The instructions feature on the packaging. Please let us know if you have an allergy to latex.
HOW ARE THE INVESTIGATIONS CONDUCTED?
Before the examination, we will explain how it is conducted and answer any questions you may have. We will ask you to undress. A blouse will be provided. After a clinical examination of the perineum, the anorectal manometry is performed. A thin catheter (4mm in diameter) is introduced in your rectum, with, at its end, a small balloon.
The examination is conducted in five stages:
1. Measuring the length of the anal canal by progressive withdrawal
Measuring pressure values at rest at various measurement sites
2. The analysis of the rectoanal inhibitory reflex with identification of the conscious perception threshold.
3. The measurement of the duration and amplitude of prolonged voluntary contraction.
4. The measurement of rectal and sphincter pressure values, during a pushing effort corresponding to simulated defecation.
5. The measurement of perception volumes during the progressive inflation of a rectal balloon.
WHAT ARE THE RISKS OF THESE INVESTIGATIONS?
The only absolute contraindication is allergy to latex, and you are required to notify us of any such allergy. Anal fissures, anorectal ulcers, or other anomalies of the anal canal or rectum can make the examination difficult. Please inform the doctor of any surgeries you have undergone. Complications may occur in exceptional cases. Bleeding, infections, and perforations are very rare, but might require medical or surgical treatment. The balloons and other accessories are sterilised as per applicable recommendations.
WHAT HAPPENS AFTER THE INVESTIGATIONS?
No special supervisions or precautions are required after the examination and you will be able to leave the consultancy unit immediately after the examination. The doctor who conducts the test will receive in the following week a report containing proposed additional medical investigations and/or therapeutic proposals. We are happy to answer any question you may have.
