High Resolution Anorectal Manometry

High Resolution Anorectal Manometry (HRAM) is a safe and low-risk test that measures the pressure and sensation in your rectum and anal canal. It uses a thin, flexible catheter (about the size of a thermometer) with many sensors to create a detailed map of muscle function. This helps your doctor understand why you may be experiencing problems with constipation or incontinence.

Why is this test done?

Your doctor may recommend this test to:

• Investigate the cause of chronic constipation or difficulty emptying the bowels.
• Evaluate fecal incontinence (inability to control bowel movements).
• Assess anal sphincter muscle function before or after surgery.
• Check for Hirschsprung’s disease in children.

What happens during the procedure?

1. Preparation: You may be given instructions to use an enema or suppository to empty your rectum 1-2 hours before the test.
2. Positioning: You will lie on your left side on an examination table.
3. Insertion: The doctor will gently insert the soft, lubricated catheter into your rectum.
4. The Test: You will be asked to perform a series of simple actions:
   • Rest: Measurements are taken while your muscles are at rest.
   • Squeeze: You will squeeze your anal muscles as if you are trying to prevent a bowel movement.
   • Push/Bear Down: You will push or strain as if you are having a bowel movement.
   • Sensation Test: A small balloon on the catheter may be inflated to measure sensation in your rectum.
5. The test typically takes 30 to 45 minutes.

After the Procedure

You can resume your normal activities and diet immediately. Your doctor will schedule a follow-up appointment to discuss the detailed results with you.

Are there any risks?

This procedure is very safe. You may feel some slight discomfort or pressure during insertion and during the balloon inflation, but it is rarely painful.