Gastroenterology - Anorectal Physiology

This leaflet has 3 aims:

1. To help you become better informed and more involved in your care.
2. To explain what happens on the day of the procedure.
3. To answer some of the questions commonly asked about the procedure.

If you have any questions, access or communication needs such as an interpreter please contact the department stated on your appointment letter.

Reasonable adjustments will be considered for all disabled users of this service.

Please make sure that you read the following information.

Your doctor has referred you for anorectal physiology studies because you are experiencing problems with your bowel. The 2 most common bowel complaints that doctors refer for this test are faecal incontinence and constipation. Other conditions also include anal fissures (small tears in the anal canal), fistulas (tracks that can form), and pre/post-surgical assessment, for example if you are having haemorrhoids treated.

When you come for your appointment, it would be helpful to us if you could bring with you a list of your medications.

If you have any heart or breathing problems/conditions, we would appreciate it if you could notify us of these conditions before you attend for your appointment.

What are anorectal physiology studies?

The test provides us with information on the strength and function of the muscles in your back passage, how well your muscles work together, and what volume your rectum (the lower part of your bowel) can hold.

What will happen during the test?

After we have asked you questions about your bowel problems and obtained your consent you will be asked to lie on a couch on your left side. A small tube will be inserted through your back passage and into the rectum. Once the catheter is in position the physiologist will measure how strong your muscles are, and you will be asked to perform certain manoeuvres such as squeezing and holding a squeeze for as long as you can. Once this has been done a small balloon will be inflated in your rectum to measure how much it can hold. You will feel as though you need to open your bowels. Be assured that it will not make you open your bowels, it is the inflated balloon that you can feel. The last part of the test will be to measure the co-ordination of the muscles in your back passage. The physiologist will ask you to push down on the balloon.

Once the tests are completed you will be free to go home. Some people feel like they need to have a bowel action after the test, this is quite normal and is due to the stimulation of the rectum, and there is a toilet close by.

How long will the test take?

We allow approximately 45 minutes for the investigations, this also includes asking you some questions about your bowel problems, explaining to you what will happen during the study and obtaining consent from you to undertake these investigations.

Will I need special medication, and will I be able to take my usual medication?

We do not ask you to take any medication prior to the test. We do not require bowel preparation, although if you have had a bowel action prior to the investigation you will find the tests more comfortable.

You can continue with your usual medication; you do not need to stop any medication.

Is the test painful?

The test should not cause you any pain. Very rarely people find it a little uncomfortable.

Will I be able to ask questions?

You can ask questions at any time prior to, during the test and after the investigation.

When will I get the results?

The results of your test will be sent to your hospital consultant or specialist nurse, and you should hear from them directly.

Benefits and Risks

The benefit of having this test is that it will help your doctor determine the problem with your back passage and/or rectum. It can help them manage your symptoms and, in some cases, decide which medication to give you. It will also help them to decide on your future management.

There are no known serious risks associated with anorectal physiology. However, there is a small risk of perforation, and the risk is less than having a colonoscopy or sigmoidoscopy (camera test to look at the large bowel which you would have had prior to the anorectal physiology).

There is no alternative to this investigation other than not going ahead with this investigation.

If you have any questions, please contact the department on your appointment letter.

Smoking Policy

Northern Care Alliance operates a smoke free policy. To find out what this means for you, pick up the leaflets available at the hospital. For advice on stopping smoking contact 0161 212 4050.