Mr Alex Leo, Colorectal Surgeon at Dottore London

If you are referred for an anorectal manometric test, today Mr Alex Leo at Dottore London offers a newer innovative technology able to get the results in a quick and reliable way. The new diagnostic test Anopress is a portable and wireless device that can be used as diagnostic examination in patients who suffer from faecal incontinence, constipation or other benign anorectal disorders. The newer technology lets us work with an estimated time of no more than 5 minutes compared to an approximate 30 minutes time of traditional devices. Therefore, the reduced procedure duration combined with the new ergonomic probes allow us to perform the test with only a minimal discomfort for the patient.

What is it?

Anorectal manometry is a specific test used for the accurate diagnosis of problems relating to the functioning of anal sphincters and pelvic floor in general. The examination can be useful for the diagnosis of many anorectal conditions, such as faecal incontinence, constipation, obstructed defecation syndrome (ODS), anal pain and anismus (pelvic floor incoordination). Manometry can also be used in the perioperative management for haemorrhoids or other minor benign anorectal conditions.

What does it involve?

The setting is similar to when the patient has the first colorectal consultation. The test is usually carried out in the outpatient clinic. The patient is instructed on basics commands such as squeeze, cough and push prior to the procedure. Before starting the procedure, the patient is then asked to lay down on the left lateral position in the outpatient couch. The physician then inserts an ergonomic and well-lubricated probe to the anal canal for a few centimetres (less than 10 cm) and takes all the necessary measurements. The test will take approximately 5 minutes causing no more than minimal discomfort

Are there any special requirements prior to the test?

Patients do not need any bowel preparation or any other special training. All patients can continue taking regular medications and there is no need for fasting or other life-style changes. Furthermore, patients do not need to be accompanied by anyone on the day of the test as this is not invasive and there are no drugs administered during the investigation.

What is the rationale?

Anal manometry allows the study of the sphincter’s functions, which are recorded during the test while resting, squeezing and straining. In this way, the physician can read any abnormalities on the screen of the device used and can therefore identify any sphincter function anomalies. More specifically, this test helps the physician to identify incontinence issues related to the inability of the muscles to contract in a proper way or difficulties and problems in defecating due to the incomplete opening and release of the sphincters muscles.

Why is it innovative?

Mr Alex Leo at Dottore London offers a new modern anorectal manometry technology: THD® Anopress. This features several advantages compared to the traditional anorectal manometry. Firstly, the new technology consists in a probe connected to a compact device that measures changes in pressure in real time, so the patients can receive the results of the test immediately after the procedure with no need of a second time interpretation. Compared to the traditional probes, which are normally introduced up to the rectum, the Anopress’ probes are smaller and therefore inserted to a maximum depth of 10 cm. The examination does not last more than 5 minutes and these combined advantages allow us to reduce the discomfort reported to minimal avoiding severe distress and pain.