Anorectal physiology involves managing non-malignant anorectal disorders such as incontinence, constipation and prolapse. Our team uses a range of tests which assess the muscles, nerves and coordination of the back passage.
Faecal incontinence and disorders of evacuation have a huge impact on quality of life.
Lower gastrointestinal or anorectal physiology investigations involve a range of tests which assess the muscles, nerves and coordination of the back passage (anal canal and rectum) in order to help direct future treatments.
Our lower gastrointestinal (GI) (or anorectal) physiology unit, which is based at Scunthorpe hospital, provides outpatient clinics, investigations and treatment for patients suffering from benign problems such as incontinence, constipation, prolapse and irritable bowel syndrome.
Lower GI forms part of the pelvic floor disciplines which include urogynaecology and urology. We organise a cross-site Pelvic Floor Multidisciplinary Meeting with these two other specialities to discuss patients and plan management in a joined up approach.
We have good communication with our community counterparts so that patients can be discharged easily and safely to the community for continuing their care.
The unit offers a light, comfortable and airy environment, which has been specifically adapted for our patients. The location of the unit, in the Lancaster Suite near to the main entrance on Church Lane, means it’s easily accessible.
Our staff provide diagnosis, counselling, and treatment.
People are often too embarrassed to seek help if their problem is associated with bottoms or bowels. Men and women of any age can be affected, with the quality of life for some people being very poor. Depending on the problem it can impact on personal relationships, their work, home life and it can leave people feeling very isolated and low.
Between 2 to 5% of people in the UK suffer with either faecal incontinence or constipation following damage to the anorectal muscle. This can happen because 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.
The investigations we carry out in the unit include anorectal manometry and endoanal ultrasound. These tests examine the anorectal muscles in detail; the strength and function of the muscle as well as looking at the damaged tissue or for more serious conditions such as tumours. We also arrange other radiological tests that are done in the radiology department such as ‘transit’ studies and defecating proctograms.
What happens during the test?
You will be asked to lie on your left side, in your normal clothes, 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 manometry part of 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 such as urge to defecate and the maximum amount you can hold on to before you would have to open your bowels – this tests your rectal capacity.
A second test will then be performed which is an ultrasound scan of the muscles in the wall of your back passage. 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 all the results patients can be offered a range of treatments.
Treatments include biofeedback counselling, which helps to retrain the anorectal muscles. This takes place over a period of 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 patients.
We run a special clinic for patients with bowel disorders that have resulted from pelvic cancer treatments, including surgery or radiotherapy
Other treatments offered include percutaneous tibial nerve stimulation (PTNS) which is a minimally invasive method used to improve faecal incontinence symptoms. You will have 12 treatments lasting 30 minutes each, followed by one or two ‘top-up’ treatments if needed. We have a room specifically designed for this.
We also provide a rectal irrigation service for both for incontinence and evacuatory problems.
We also provide surgery if conservative treatment is not successful. This is usually needed in only 5-10% of all patients seen in the Lower GI department. Surgery includes anal sphincter repair, rectal prolapse surgery, rectocele repair, laparoscopic rectopexy, stoma (ileostomy/colostomy) formation etc.
Patients can be referred directly to the unit from their GP.
Scunthorpe hospital: 01724 203401