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Measuring the movements or motility of the rectum and anal canal helps determine if any difficulty in pooping is related to issues with functioning of the anorectal muscles. An anorectal manometry study is usually done when there is difficulty in bowel movements or soiling. It can also be used to determine if any underlying neuromuscular condition could be present. The study is also helpful in children who have had operations for anorectal malformations such as imperforate anus or Hirschsprung’s disease.
A thin plastic tube with sensors, and a small balloon at the tip, is passed rectally. When the tube is placed, it may cause abnormal sensation or some minor discomfort. The probe is attached to a computerized system measuring the pressure and the pressure tracings are noted on the computer monitor. Once the placement of the tube is in appropriate position, it is taped to the surrounding buttocks.
Once the catheter is secured in position, we offer your child to rest for a few minutes to get baseline pressures. After this, we record the sphincter response to a swift puff of air into the rectal balloon to measure the Recto Anal Inhibitory Reflex (RAIR). We may ask your child to squeeze the sphincters like trying to hold the poop, and then to push like trying to have a bowel movement. Lastly we may measure the sensation by slowly inflating the rectal balloon to determine when your child is able to feel the presence of the balloon, and the sensation or urge to poop.
Your child may experience abnormal sensation, or minor discomfort with the study, but it is typically very transient. Although possible, the chances of serious complications are extremely low.
Depending on the ease with which the measurements are completed, usually the study takes about 20-30 minutes to complete.
We will analyze the study and provide a complete report to you and your child’s referring provider. We may ask you to come for follow up visits to the GI Motility Clinic to discuss the findings and/or further management options.
An anorectal manometry tracing looks like this:
- Non sedated procedures are done at set times provided to you. Please arrive to the designated registration at least one hour prior to your scheduled time.
- Often parking and entry to the hospital takes another 30 minutes or so.
- Your child should have an enema the morning of the study.
- Your child is allowed to eat and drink prior to the study.
- The nurse will review all instructions with you at the time of the study.