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About your anorectal physiology studies examination

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What is it?


Anorectal Physiology Studies look at the function of the back passage and rectum.

We carry out different tests which give information about what is causing your problem, whether it is difficulty in controlling your bowel (incontinence) or constipation.


    Before the test


    NO preparation is required prior to the tests. You may eat and drink as normal before and after the test and take any prescribed medications as normal.


      Who will carry out the tests?


      Your test will be carried out by a specially trained nurse or consultant. There will be a chaperone present in the room and your privacy and dignity will be maintained at all times.

      You will be asked to remove your lower half clothing and lie on a couch on your left hand side.

      The practitioner will perform a gentle rectal examination to check the rectum is empty and that you are able to squeeze when requested to.


        The tests


        Manometry

        A small tube (about the size of a straw) called a transducer will be inserted into your rectum. This allows us to measure the pressures your muscles can generate. It then transmits them to a graph.

        You will be asked to ‘test’ your sphincter muscles by squeezing and coughing.

        Rectal compliance and sensation

        A small balloon attached to a tube (about the size of a straw) will be inserted into your rectum. Small volumes of water will be used to inflate the balloon. You will be asked to verbally record when you feel a change in sensation in your back passage as the balloon inflates.

        Endo anal ultrasound

        An ultrasound probe (about the width of a finger) will be inserted into your rectum to look at the sphincter muscles. A 3D Scan will be recorded to look for any breaks or irregularities within the muscles.

        Pudendal nerve latencies

        This test assesses the function of the nerve which supplies the back passage muscles (rectum). It involves placing a gloved finger with a stimulating electrode into your back passage. You may feel a twitching sensation as the nerve is stimulated. These tests can help to plan any further treatment. This will be discussed with you at a separate appointment with the consultant who has referred you.

        Please note, you may not require all the tests.


          Will the tests be painful?


          Some patients have described the tests as uncomfortable, rather than painful.


            How long will the tests take?


            They usually take about 20-30 minutes to complete.


              Risks and benefits of investigations


              There are no reported risks with these investigations. However, possible infection cannot be discounted.

              The investigations are beneficial in as much as they enable a more accurate diagnosis to be made.


                Are there any alternatives?


                There are no alternatives to these investigations. They are simple and minimally invasive.


                  What will happen after your tests?


                  You will be able to resume normal activities following the tests.


                    Finding out the results


                    Once the tests have been completed, a report will be sent to your consultant and GP.

                    The lead consultant for anorectal physiology problems will fully analyse all the information and decide further management and follow up.


                      Further appointments


                      If you require any additional information concerning the investigations or any advice please contact:
                      Royal Sussex County Hospital
                      Eastern Road, BN2 5BE

                      Telephone: 01273 696955, extension 4667.

                      If unavailable, please leave a message and you will be contacted.


                      Useful contacts

                      The Digestive Diseases Foundation

                      This organisation is a registered charity that offers advice and information on digestive problems. They can be contacted at:
                      3 St Andrew’s Place
                      London
                      NW1 4LB

                      The Continence Foundation

                      This organisation offers help and advice and has an established help-line service. They can be contacted at:
                      307 Hatton Square
                      16 Baldwin gardens,
                      London,
                      EC1N 7RJ.

                      Telephone: 0207 404 6875

                      Helpline: 0207 831 9831 (Monday to Friday 9.30 – 4.30).


                      Where to find us


                      We are in the Digestive Diseases Centre, Level 9, Thomas Kemp Tower. Access is via the Millennium Wing. Please report to reception on arrival.


                      What do I do if I need to cancel or change my appointment?


                      If you need to cancel or change your appointment please call us on 0300 303 8517.


                      This information is intended for patients receiving care in Brighton & Hove or Haywards Heath.

                      The information here is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.


                        Publication Date: November 2018

                        Review Date: May 2022

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