Anorectal Manometry

Anal manometry provides important information about the functional status of the anal sphincters and distal rectum. There is no standardized method of manometric evaluation, although several methods have been described.1 Microtransducers can be used in the anal canal and are well tolerated by patients. Multichannel water perfused catheters are perhaps the most common tool used to perform anal manometry. Flow rates of 0.3 mL per channel per minute are required to adequately measure outflow pressure.2 Higher flow rates can result in accumulation of fluid and distortion of the measurements.

The resistance of flow from the catheter determines pressure measurements, which can be taken in a continuous manner (continuous pull-through) or at set levels within the anal canal (station pull-through). The continuous pull-through technique requires the catheter to be removed at a continuous speed from the anal canal, using a computerized motor. This technique can provide a detailed recording of both the radial and longitudinal pressure profiles, while computer analysis can then generate a three-dimensional representation of the anal canal. The station pull-through technique measures anal canal pressures at 1-cm increments in the anal canal. It has been the orized that this method provides a more accurate assessment of anal pressures because there is a stabilization period before each reading, thereby reducing artifact.3 This is the method used at the Cleveland Clinic Florida. The tip of the catheter is placed at 6 cm cephalad from the anal verge. Anal pressure measurements are taken at 1 cm intervals after stabilization of the catheter for 20 to 30 seconds. Rest and squeeze pressures are recorded at each centimeter up to 1 cm from the anal verge. After documentation of the pressures in the anal canal, rectal capacity, compliance, and rectoanal inhibitory reflex are tested. The evaluation of the rectal capacity will provide information regarding the rectal potential to accommodate the fecal matter if defecation must be delayed.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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