Advanced testing to diagnose anal and rectal conditions
If you're dealing with issues like constipation, incontinence, or pain, you're not alone—and we can help you find answers. At MedStar Health, we offer advanced testing to understand how your anal and rectal muscles are working. These tests help us find out what's causing your symptoms so we can create a treatment plan that's right for you.
Our team includes specialists in gastroenterology, colorectal surgery, pelvic floor therapy, and more. We work together to make sure your care is personalized, accurate, and as comfortable as possible. With the right testing, we can understand the best next steps to help you feel better and get back to doing what you love.
Understanding anal and rectal physiology
The anal and rectal region is crucial for healthy digestion and bowel control. These areas are made up of muscles, nerves, and tissues that work together to help you pass stool comfortably and efficiently.
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Rectum: The rectum is the last part of your colon. It acts as a holding chamber for stool until you’re ready to pass it. The muscles in the rectum expand when stool enters and contract to push it out during a bowel movement.
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Anal sphincters: The anal sphincters are two muscles that control the opening and closing of the anus. The internal anal sphincter works automatically to keep the anus closed, while the external anal sphincter allows voluntary control over bowel movements.
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Pelvic floor muscles: These muscles support the bladder, rectum, and other organs in the lower abdomen. When these muscles are weak or not functioning properly, it can lead to issues with bowel control or chronic constipation.
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Nerves: Nerves in the anal and rectal area help control the feeling of urgency and the ability to hold or release stool. Dysfunction in these nerves can cause problems like incontinence or difficulty passing stool.
When something goes wrong with any of these systems, whether it's muscle weakness, nerve dysfunction, or abnormal stool movement, diagnostic tests can help us identify the issue. From there, we create a personalized treatment plan to get you back to feeling your best.
Why you might need anal or rectal testing
Diagnostic tests can help evaluate conditions such as:
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Fecal incontinence (difficulty controlling bowel movements)
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Difficulty emptying the bowels
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Pelvic floor dysfunction
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Anal or rectal pain or pressure
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Pain or dysfunction after childbirth or surgery
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Rectal bleeding
If you’ve had these symptoms and haven’t gotten clear answers, these tests can give us the information we need to help.
Diagnostic procedures we offer
At MedStar Health, we use a range of advanced diagnostic tests to get a complete picture of your anal and rectal health. These tests help us:
- Measure the strength and function of the anal sphincter muscles
- Evaluate the integrity of the muscles
- Understand the mechanics of defecation and how well stool moves through the colon
This comprehensive approach allows us to identify the root cause of your symptoms and develop a personalized treatment plan to improve your quality of life.
Anorectal manometry
Anorectal manometry helps us understand how well the muscles and nerves in your rectum and anus are working. It’s commonly used if you’re experiencing chronic constipation, fecal incontinence, or trouble with bowel control. During the test, a small, flexible tube is gently inserted into the rectum to measure muscle strength, coordination, and sensation. This gives us valuable information about how your body responds when you're at rest, when you squeeze, and when you feel the urge to go.
This outpatient test typically takes about 15 to 30 minutes and doesn’t require sedation.
Rectal and anal ultrasound
Anal and rectal ultrasound uses sound waves to create detailed images of the muscles around the anus and rectum. It’s especially helpful if you're dealing with incontinence, muscle weakness, or have a history of childbirth or surgery that may have affected these muscles. A small probe is placed in the rectum to show the structure and condition of the anal sphincters. We can also use this test to measure the depth of tumors when evaluating rectal cancer.
The ultrasound is performed in a comfortable outpatient setting and is quick, with little to no discomfort.
Defecating proctogram
A defecating proctogram shows how your pelvic floor muscles and rectum work when you try to pass stool. Your doctor may recommend this test if you’re having trouble emptying your bowels, or if you have symptoms of rectal prolapse (when part of the large intestine slips through the anus) or rectocele (a bulge in the anal canal caused by weakened muscles). Also called MRI defecography, this test is done in our radiology department. During the test, you’ll be asked to mimic a bowel movement while images are taken. These images help us see how the organs move and if anything is out of place.
The procedure takes about 30 to 45 minutes and is noninvasive.
Colonic transit time study (Sitz marker study)
A Sitz marker study tracks how long it takes for stool to move through your colon. If you’re dealing with long-term constipation or suspected slow-transit colon, this test can help. On the first day, you swallow a capsule containing 20 tiny markers. Then, we take X-rays on days three and five to see how far the markers have traveled. This helps us understand how your digestive system is functioning over time.
This test requires two X-ray visits over the course of a week.
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Frequently asked questions
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Is anorectal testing painful?
Most tests cause minimal discomfort and are performed without sedation.
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Do I need to prepare before testing?
Some tests may require fasting or additional preparation. We’ll provide full instructions beforehand to get you ready.
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Will insurance cover these tests?
Many diagnostic tests are covered by insurance. Our team will work with you to verify your coverage before scheduling.