Our office provides comprehensive lower intestinal diagnostics and services to the community.  Your physician will decide when this testing is right for you.

WHAT IS ANAL ULTRASONOGRAPHY? Anal ultrasound is a non-surgical diagnostic tool used to provide information on the continence muscles of the anorectum. A specialized probe allows for visualization of these muscles through the use of a non-painful non-radiating probe. This procedure offers valuable information on the integrity of the muscles and aids in forming a treatment plan.

WHAT IS ARM?  AnoRectal Manometry (ARM) is a non-surgical diagnostic tool used to provide information about the pressure and function of the rectum and anal sphincter.  These muscles ring the anal canal and control bowel movements by relaxing and contracting.  A specialized catheter allows for the measurement of the pressure exerted by the sphincter muscles.  This procedure is not painful and offers your physician valuable information to aid in forming a treatment plan.

PURPOSE:  Anal ultrasound and ARM helps diagnose the cause of chronic constipation, fecal incontinence, or incontinence of gas which may be due to:

  • Rectal/Anal Trauma
  • Weakness due to chronic over-distention
  • Systemic disease such as diabetes which may affect sensation
  • Pelvic Trauma

HOW IT WORKS:  A blunt ultrasound probe no wider than your thumb is inserted into the rectum. A series of rest/squeeze/and defecatory maneuvers are done to assess the anorectal muscles. For ARM, a thin catheter is inserted through the anus and into the rectal canal.  The catheter is narrower than a drinking straw so it will cause little, if any, discomfort.  This specialized catheter measures pressure from many directions at the same time.

TEST PROCEDURE:  You will be asked to lie on your side with knees bent.  The doctor examines your rectum with a gloved finger.  The ultrasound probe is inserted to take pictures of the anorectal muscles during different maneuvers. For ARM, the manometry catheter, a thin tube of soft plastic with a balloon at the tip, is inserted into your rectum.  This catheter transmits the pressure recordings to a computerized testing system.  At times during the test, the catheter may be slowly moved from one position to another.  You will be asked to squeeze the anus as forcefully as possible or to keep these muscles completely relaxed.  The balloon at the tip of the probe will be inflated.  You should report when you have a sensation that your rectum is full and when you feel an urge to defecate.  You may be asked to expel the balloon as you would a bowel movement.

AFTER THE TEST:  You are free to return to previous activities.


You will be asked to purchase 1 Fleets Enema and complete it the night before the testing.
Stick to a soft diet the day of your test (applesauce, yogurt, broth)
Plan to stay about an hour for your appointment.  This will include pre- and post-test meetings with the physician.
It is a good idea to wear comfortable clothing as you will need to remove clothing below the waist.  If you use pads or absorbent products, please bring a replacement with you.
If you have any additional questions, please call your physician’s office.
You may be asked to keep a record of your bowel habits as well as fluid and diet intake to show to the physician.
Bring a list of medications, as these may have an effect on the bowels and bowel movements.