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Anorectal manometry (ARM) is a medical test used to measure pressures in the anus and rectum and to assess their function. [ 1 ] [ 2 ] The test is performed by inserting a catheter , that contains a probe embedded with pressure sensors, through the anus and into the rectum. [ 3 ]
The rectoanal inhibitory reflex (RAIR), also known as the anal sampling mechanism, anal sampling reflex, rectosphincteric reflex, or anorectal sampling reflex, is a reflex characterized by a transient involuntary relaxation of the internal anal sphincter in response to distention of the rectum. [1]
Anismus can be subcategorized into 4 types based on the results of anorectal manometry testing: [22] Type 1: The patient can generate and adequate rise in intra-abdominal pressure, yet there is a paradoxical increase in anal sphincter pressures.
It has also been reported that there is a high false positive rate of anismus diagnosis with anorectal manometry for similar reasons. [5] Rectocele: This is the most common finding with this type of imaging. Almost always, this is an anterior rectocele where the anterior rectal wall bulges forward, into the vagina in females.
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Furthermore, 2 of the following 3 tests must show abnormal results: balloon expulsion test, anorectal manometry or anal surface electromyography, or imaging (e.g. defecography). [31] Two subcategories exist within the functional defecation disorders category: Inadequate defecatory propulsive (F3a) and Dyssynergic defecation (F3b). [31]
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This test is usually done in a doctor's office. The patient is required to remove their underwear, and must either lie on their side on top of an examining table, with their knees bent up towards the chest, or bend forward over the table. The anoscope is 3 to 4 inches long and the width of an average-to-large bowel movement.