Anorectal Manometry is an exam that allows real time graphic recording of pressure patterns in the anal canal and rectum. It is a fast-paced exam, which does not require preparation in most cases, or sedation. So, the patient is then released to normal activities. It is not required to have company with you on the day of the exam.
At the tip of this catheter, there is a small balloon that is inflated at some moments of the exam, which makes it possible to estimate the sensitivity and capacity of the rectum, as well as reflexes and aspects related to the dynamics of defecation. The exam can be performed with pneumatic (less common), hydropneumatic, or solid catheter equipment.
The exam is performed by the colorectal surgeon, by the introduction of a thin catheter (like a straw, thinner than a pen), which is introduced up to the rectum and then positioned along the entire anal canal and part of the rectum. It allows recording of pressures along these segments, which are related to the functioning of the pelvic floor muscles, including those that form the anal sphincters.
We chose the solid catheter equipment because it is more comfortable for the patient and because it generates fewer artifacts (alterations) on the exam, due to the constant stimulation of the anal margin by the water flow during the exam, which happens when hydropneumatic devices are used. This equipment makes it possible to register the exam with high precision and practicality.
The exam is performed with the patient lying on his side. The catheter is inserted and the examiner performs several maneuvers and measurements, all explained to the patient during the exam. The graphic record is added to the report, as well as objective measurements and subjective impressions, which are described later.
Among the various indications of the Anorectal Manometry exam, we highlight intestinal constipation with dyschezia (i.e., constipation when difficulty to defecate is observed), fecal incontinence (involuntary loss of gas and/or feces), the investigation of specific reflexes and documentation of anal function before and after anal surgeries.