Anorectal Manometry & Balloon Expulsion
Measures the muscles of the anus and rectum — essential for diagnosing pelvic floor dyssynergia and fecal incontinence. Quick, mildly uncomfortable, no sedation.
Results
Within 1 week.
This article is educational and does not replace your doctor's advice. Seek urgent care for any red-flag symptoms.
What is it?
A thin pressure-sensing catheter (about the diameter of a pencil) is gently inserted into the rectum. It measures resting and squeezing pressures of the anal sphincters, sensation thresholds in the rectum, and what your muscles do when you bear down. Combined with the balloon expulsion test (you try to push out a small water-filled balloon), it diagnoses pelvic floor dyssynergia.
Why is it done?
To diagnose pelvic floor dyssynergia (the cause of constipation when laxatives don't work), evaluate fecal incontinence, assess anal sphincter function before or after surgery, and check for Hirschsprung's disease in young patients.
Who needs it?
- Chronic constipation not responding to laxatives
- Fecal incontinence
- Pre-/post-surgical sphincter assessment
- Suspected Hirschsprung's disease
Before the procedure
- Empty bowel — most clinics ask you to use a small enema 1 hour before.
- No special diet.
- No sedation needed; no driving restriction.
During the procedure
You lie on your side. The thin catheter is gently inserted into the rectum. The technician asks you to: squeeze, relax, bear down (push as if defecating), and tell them when you feel a balloon being inflated in the rectum (sensation testing). Then a small water-filled balloon is placed in the rectum and you sit on a commode and try to expel it. Total: 20-30 minutes. Mildly uncomfortable but not painful.
After the procedure
You can leave immediately. No restrictions on activity, eating, or driving. Mild rectal discomfort for a few hours. Results usually within 1 week.
Risks
- Discomfort during catheter insertion
- Mild rectal bleeding from existing hemorrhoids: rare
- Vasovagal reaction: rare
When you get results
Alternatives if you decline
Defecography (X-ray or MRI during defecation) provides anatomical information but is more involved and not always needed.
In the Saudi context
Anorectal manometry is available at several Saudi tertiary centers (KFSH, KFMC, KAMC) and a growing number of private hospitals in Riyadh and Jeddah. Reluctance to discuss bowel function delays many patients — this is a routine test for GI clinicians.
Questions to ask your doctor
Save this list or print it before your appointment — doctors appreciate prepared patients.
- Could pelvic floor dyssynergia be the cause of my constipation?
- Will biofeedback help me?
- Is biofeedback covered by my insurance?
Medically reviewed by: SGA Patient Education Panel · Last reviewed 24/04/2026