What is anorectal manometry and what measures
Anorectal manometry is a technique that allows the registration of the pressures, reflexes and sensitivity of the anorectal area.
With it you can measure:
- The length of the sphincters
- Anal pressure at rest, which basically depends on the integrity of the internal anal sphincter
- The maximum anal pressure after voluntary contraction due to external anal sphincter
- Rectal sensitivity, assessable by blowing air from a balloon, located in the rectal area, and informs us of sensory thresholds and evacuation
- The cough reflex, which evaluates us defects specific nerves in this area
- The expulsive reflex, where we see a relaxation of the external sphincter with the effort to evacuate. If it does not happen, we are facing a paradoxical contraction of the external sphincter or anism.
- Anal inhibitory reflex and relaxation of the internal anal sphincter to distention of a rectal balloon. If it does not happen, we are faced with Hirschsprung's disease or aganglionic megacolon.
Such exploration can be done with conventional manometry or high - resolution manometry, which provides tomographic images in color of this area.
How is a anorectal manometry is performed and what the procedure
Anorectal manometry is performed by introducing a lubricated probe about eight centimeters long in the rectum, carrying a small latex balloon at its end, with a diameter of just over a centimeter and that can record pressures in part front, back, left and right, of the anorectal area, being the patient in left lateral decubitus.
The patient, at specific times of the test is made to cough, strain retention and removal of the probe, which informs the expert Digestive whether perceived initial feeling of evacuation or if the feeling is urgent.
It is a noninvasive and well tolerated test that lasts about 30-45 minutes, since the patient arrives until it leaves consultation with the report it.
Where anorectal manometry is necessary
Anorectal manometry is used to study:
- A sharp, lasting or severe constipation
- fecal incontinence
- Control of the anorectal area before and after anal or rectal surgery
- anal pain
- anal fistulas
- Pelvic floor disorders
It is also almost diagnosis of Hirschsprung's disease.
In addition, the anal Biofeedback is a therapeutic technique in cases of fecal incontinence (to improve sphincter tone), and rectal Hyposensitivity anism (to return to power relax the external anal sphincter before straining).
Preparation before anorectal manometry
For the area not present stool or fecal impaction (stool cap), you should put an enema of 150-200 cc 2-3 hours before the test.
The doctor, among other questions you perform, should know if the patient is allergic to latex, since the balloon carrying at the end of the probe is of this material and if you have allergies, should be replaced by another.