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Patient Information – Ano-rectal Physiology Introduction You have been referred by your consultant for ano-rectal physiology. This is to study the function of your anus and back passage (rectum). It can involve different tests that give information about what is causing your problem, whether it is difficulty in controlling your bowel (incontinence) or constipation. This leaflet is intended to answer some of the questions you may have about your tests. Pudendal nerve testing This test assesses the function of the pudendal nerve which supplies the back passage muscles (rectum). The test involves the consultant placing a gloved finger with a stimulating electrode into the back passage (rectum). Several mild electrical impulses are given to assess the nerve function of your back passage (rectum). You may feel a twitching sensation during this test and will take approximately five minutes. Anal manometry This gives information about the strength of the muscles that control your bowel movements. It is carried out by placing a small tube the size of a drinking straw with a small balloon on the end into your back passage (rectum). The allows us to measure the pressures the muscles generate in your back passage (rectum) and transmits them to a graph which shows for example, whether your muscles have been weakened. This will take approximately 10 minutes to complete. Page 1 of 5 Rectal compliance testing This gives information about the function of the back passage (rectum). A small tube the size of a drinking straw with a small balloon on the end is inserted into your back passage. The small balloon is filled with water whilst in your back passage (rectum). You will be asked when you can first feel a change in sensation in your back passage (rectum) as the balloon is filled with water. The balloon will continue to be inflated until the sensation of needing to pass a bowel motion is felt. You will also be asked when you cannot hold onto the balloon any longer. The test is painless and takes approximately five minutes to complete. What are the risks, benefits and alternatives? Ano-rectal physiology and ultrasound tests are safe and have no known side effects. However when a tube is inserted into the back passage (rectum) there is an extremely low risk of the tube accidentally going through the wall of the back passage (rectum) this is called perforation. Some patients may find the insertion of the tube or probe into the back passage uncomfortable. The tests will help plan any further treatment which will be discussed with you at a separate outpatient appointment by your consultant. The tests may show you do not need any further treatment. There are no alternative tests to obtain information about the function of your back passage (rectum). Do I need to do anything before my appointment? You can eat and drink normally before your appointment. Page 2 of 5 What should I expect during my appointment? When you arrive for your appointment you will be asked to remove the bottom half of your clothing. You may wish to bring a dressing gown and slippers with you. Your consultant or nurse specialist will explain the tests planned for you. You will be asked to lie on your left hand side on an examination couch. Your privacy and dignity will be maintained at all times. It is not necessary for you to be put to sleep or sedated in any way. Your consultant or nurse specialist will explain during the tests anything you need to do to give us as much information as possible about your muscle function. This may include being asked to cough and also to squeeze the muscles in your back passage (rectum) as if you were stopping a bowel movement. You may also be asked to “bear down” as if trying to pass a bowel movement. The tests will take approximately 10 to 15 minutes to complete. Will I be able to go back to work? Yes. After your appointment you will be able to continue your day as normal. When will I find out the results of the tests? Once your consultant has reviewed all the information from the tests a follow up appointment will be sent to you. Your consultant will then discuss the results with you and arrange further treatment if necessary. Where can I find the ano-rectal physiology clinic? Located within the endoscopy unit at the Queen Elizabeth Hospital. You need to report to the endoscopy unit reception on arrival. Page 3 of 5 The clinic is held usually on Friday’s between 9.00am and 1.00 pm or 2.00pm and 5.00pm. What happens if I have any problems? If you have any questions either before or after your appointment you can contact the nurse specialist Monday to Friday 9.00am – 5.00pm on the number below. Colorectal Nurse Specialist Queen Elizabeth Hospital Sheriff Hill Gateshead Tyne and Wear NE9 6SX Tel: 0191 4453150 or 0191 4820000 Bleep 2041 Outside office hours you may leave a message on the answer phone Tel: 0191 4453151 and your call will be returned by the next working day. Further information Bladder and Bowel Foundation SATRA Innovation Park Rockingham Road Kettering, Northants, NN16 9JH Helpline: 0845 345 0165 Email: [email protected] Website: www.bladderandbowelfoundation.org Patient information developed in conjunction with ano-rectal physiology services at City Hospitals Sunderland. Page 4 of 5 Data Protection Any personal information is kept confidential. There may be occasions where your information needs to be shared with other care professionals to ensure you receive the best care possible. In order to assist us improve the services available your information may be used for clinical audit, research, teaching and anonymised for National NHS Reviews. Further information is available in the leaflet Disclosure of Confidential Information IL137, via Gateshead Health NHS Foundation Trust website or the PALS Service. Information Leaflet: Version: Title: First Published: Review Date: Author: NoIL120 5 Ano-rectal Physiology November 2007 August 2016 Claire Egglestone This leaflet can be made available in other languages and formats upon request Page 5 of 5