General Surgery

Anorectal Physiology Service

What is anorectal physiology?

Anorectal physiology is a test that looks at the strength of the muscles in your anal canal to see if they are working normally.

Our specialist unit at Scunthorpe General Hospital is run by clinical nurse specialists under the direction of one of our lead Colorectal Consultant Surgeons, Miss G Kaur. We provide specialist investigations and treatment for patients with functional bowel disorders. The anorectal physiology unit provides a seamless service; investigating, analysing and treating patients with varying symptoms. Patients can be referred directly to the unit from their GP.

Between 2 – 5% of people in the UK suffer with either faecal incontinence or constipation following damage to the anorectal muscle. This can happen as a result of childbirth, following surgery or as a result of other medical conditions. Often the problems associated with injuries of this kind may not become evident until later life.

What will happen when I visit the unit?

Anorectal manometry and endo-anal ultrasound scans can be carried out as an outpatient procedure. These tests examine the ano-rectal muscles in detail. The tests can look at the strength and function of the muscles as well as looking at any damaged tissue or for more serious conditions such as tumours.

You will be asked to wear a hospital gown for the procedure and lie on your left side, covered with a sheet. Every effort will be made to preserve your privacy and dignity during the procedure but the nature of the test means that some ‘intimate’ contact is unavoidable.

For the test, a small tube is put into your back passage (rectum).  This will measure the pressure of the muscles in your rectum and anus.  At different times you will be asked to cough, and to squeeze your bottom.  A small amount of air will be flushed into the balloon at the end of the tube.  This will simulate the normal filling of your rectum and will show how your bowel responds to this.

You will need to tell us when you are getting any sensations of your rectum filling.
A second test will then be performed which is an ultrasound scan of the muscles in the wall of your bowel.  The probe, which is about the size of an adult finger, will be positioned inside your rectum and the scan will take place.

Following analysis of the results patients can be offered a range of treatments including biofeedback counselling, which helps to retrain the ano-rectal muscles. This takes place over a several months enabling the patient and nurse to establish a trusting relationship. This is important as for many people, talking about their symptoms is difficult or embarrassing. This treatment improves the function of the muscle without the need for surgery, leading to the promotion of continence and improved quality of life for these patients.

Our unit is available to answer any questions you or a family member may have regarding your appointment, or perhaps you have been seen in our clinic and still have some more questions. Please contact us should you require any further information.