Miss Boorman offers a range of non invasive treatment options to help with the diagnosis and treatment:
What are anorectal physiology studies?
These tests assess the strength and function of the anal sphincter muscles. The tests also look at the coordination of these muscles, and how much volume the rectum can hold.
How to prepare for anorectal physiology studies
There is no preparation required for this test. You may eat and drink as normal before the test. Please continue to take your usual medication.
What to expect during anorectal physiology studies
After your written consent has been obtained, you will be asked detailed questions about your symptoms and you may be asked to complete symptom score sheets.
After a history has been taken, we will commence the tests. There are two tests that we perform, which will take approximately 30 minutes. We will ask you to lie on your left-hand side. The first test involves inserting a small catheter (tube) a few centimetres in to your back passage. We will ask you to perform certain manoeuvres to test the strength of your sphincters such as squeezing and coughing. We will then inflate a small balloon that is attached to the catheter to assess sensation. To assess the coordination of your anal muscles we will ask you to push down on the balloon.
The second part of the test is an endoanal ultrasound scan. This takes an ultrasound image of the anal muscles. A tube, about 2cm in diameter is inserted a few centimetres into the back passage.
The whole process will take approximately one hour.
When can I expect the results?
When the test is complete, the Physiologist will talk you through the results. The report will then be finalised and sent to your referring doctor who will then decide on the next steps. These may be further tests or discussion at the Pelvic Floor Multi-Disciplinary Team meeting. If you have any questions at the time of your appointment, please feel free to ask the member of staff performing your test.
What are the benefits and risks?
These tests will help your doctor to accurately diagnose your bowel problem. It will also assist the doctor on how to best manage your symptoms and decide the best course of treatment. There are no risks associated with anorectal physiology studies. Most commonly patients may find the tests uncomfortable.
Anorectal Physiology tests
The thought of having a test on their back passage can be very embarrassing and frightening. It is however, important to point out to you that these tests are not painful and are only carried out by sympathetic, highly trained professionals who will endeavour to maintain your dignity at all times. The tests are an important part of the investigation of your bowel condition and will help us to decide the best treatment for your problem. When you arrive to have your tests you will once more be asked a number of questions about how your bowel works and the problems that you have been having. The tests then take about one hour to complete. Tests comprise:
This is divided into two parts. You will be asked to lie on an examination couch on your left side with your knees bent.
Anal pressure measurement. This measures the strength of the muscles in your back passage and involves introducing a small tube, about the size of a drinking straw, into your anus. You will be asked to squeeze and relax the muscles and their strength can be measured.
Rectal sensation and pressure measurements assesses the amount that your rectum can hold. This involves passing another small tube with a balloon attached to it. The balloon is inflated and you will be asked to confirm when you can feel that it is filling up. We will also measure the way the muscles relax using the same tube that was used for the first part of the test.
Pudendal Nerve Test
In some patients we we will test the function of the nerves controlling the anal sphincter muscles. To do this a small electrode is passed into the rectum on the finger of a rubber glove. This passes a very small electric current over the nerves which will cause the muscles in your back passage to twitch. This procedure can be a little uncomfortable but is not painful.
This test is designed to investigate if there is any numbness in your back passage that might prevent you feeling your motions coming down. A tiny probe attached to a small battery is inserted into your bottom and a small electric current is slowly increased until you can just feel it as a tingling sensation.
Ultrasound scans (pictures) of the muscles of your back passage are taken by passing a finger-sized probe into the anus with you lying on your tummy. This is not painful. This test can demonstrate if there has been any damage done to the anal sphincter muscles eg following childbirth.
Frequently asked questions
Are there any alternative tests?
There are no alternatives available.
Will it be painful?
The test should not be painful. The test may seem embarrassing but it a common test performed by the department and your privacy and dignity is maintained at all times. If you are in pain, please let the staff member performing your tests know and they will stop.
Will I be able to go about my normal activites after the test?
Yes, the tests do not require sedation or anaesthetic and you will be free to leave once they are complete.