Anorectal Manometry

ARM is a test used to evaluate the function and coordination of the sphincter and pelvic floor muscles of the anorectal region. The study also measures resting and squeeze pressures, as well as the length of the anal canal.

Reasons for Performing Anorectal Manometry

ARM is performed to better define the following conditions:

  • Fecal incontinence
  • Chronic constipation
  • Rectal prolapse
  • Pre-op to evaluate sphincter competence prior to surgery

Preparing for Your Anorectal Manometry Test

  • Purchase 2 Fleet® enemas from your local pharmacy 7 days prior to your procedure.
  • The day of your procedure do NOT eat or drink anything for 2 hours prior to your scheduled appointment.
  • You may take your morning medications with a small sip of water.
  • Give yourself one Fleet® enema 2 hours before your appointment. If you have no bowel movement after the enema, you will need to do it again with the second fleet enema.
  • You should arrive to your appointment 30 minutes before your schedule appointment.

Overview of the Anorectal Manometry Procedure

A nurse will perform anorectal manometry after discussing the procedure in detail. You will lie on your left side with your hips and knees flexed. A small, flexible, well lubricated catheter, about the size of a thermometer, with a balloon at the end is inserted into your rectum. The catheter is connected to a monitor that measures the pressure of several muscles in your rectum. During the study, the small balloon will be inflated to assess the normal reflex pathways. You will be asked to squeeze, relax, and push at various times allowing the nurse to measure the anal sphincter muscle pressure. Two other tests may be performed: (1) An anal sphincter electromyography (EMG) that evaluates the nerve supply to the anal muscle and (2) Balloon Expulsion Test used to measure the time it take to expel the balloon from the rectum.

What can be learned from ARM?

The anal and rectal area contains specialized muscles that are helpful to regulate proper passage of bowel movements. Normally, when stool enters the rectum, the anal sphincter muscle tightens to prevent passage of stool at an inconvenient time. If this muscle is weak or does not contract in a timely way, incontinence (leakage of stool) may occur. Normally, when a person pushes or bears down to have a bowel movement, the anal sphincter muscles relax. This will cause the pressures to decrease allowing evacuation of stool. If the sphincter muscles tighten when pushing, this could contribute to constipation.

Anal manometry measures how strong the sphincter muscles are and whether they relax as they should during passing a stool. It provides helpful information for patients struggling with fecal incontinence or severe constipation. There are many causes of fecal incontinence. Weak anal sphincter muscles or poor sensation in the rectum can contribute to fecal incontinence. If these abnormalities are present, they can be treated. Biofeedback techniques using anal manometry and special exercises of the pelvic floor muscles can strengthen the muscles and improve sensation. This can help treat fecal incontinence. There are many causes of constipation. Some involve sluggish movement through the whole colon, whereas others involve the anal sphincter muscles. In some patients with constipation, the anal sphincter muscles do not relax appropriately when bearing down or pushing to have a bowel movement. This abnormal muscle function may cause a functional type of obstruction. Muscles that do not relax with bearing down can be retrained with biofeedback techniques.

Duration of Treatment?

The procedure will take approximately 30 minutes.

What to Expect After Your Anorectal Manometry Test

You may drive yourself home, eat and go about your normal activity after the procedure is complete. Please schedule follow-up visit with Urogynecology of Kansas City to discuss results of the study. Contact our office with any unusual symptoms or side effects.

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Veronica Malm
October 16, 2026
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I am so grateful to have found Dr. Nosti. He is incredibly kind, patient, and always takes the time to answer all of my questions. He is an outstanding professional, and I feel very fortunate to have been under his care. His entire team, from the clinic staff to the operating room team, was truly wonderful.Everyone was extremely professional, attentive, compassionate, and supportive exactly what you need when going through surgery. Six weeks after my surgery, I can honestly say that I would rate this entire team a 10/10, both professionally and, just as importantly, on a human level. Thank you, Dr.Nosti, and thank you to the entire team for taking such great care of me. I couldn’t be more grateful!💕
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Michelle Butcher
October 14, 2026
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I live in Eastern Jackson County. We have trouble in this area seeing sub specialists. He comes to this area once a month and I truly appreciate him for this. He is very understanding friendly and gives me his full attention. His staff are very nice as well. I would give his name out to anyone who needs help with these kind of problems. He gets five stars from me.
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Dana Smith
September 25, 2026
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I can't recommend Dr. Nosti and the team at Urogynecology of Kansas City enough. I had surgery with him last month, and from my very first evaluation appointment through recovery, the entire experience exceeded my expectations. Dr. Nosti took the time to listen, explain my options clearly, and made me feel confident and comfortable with my decision to move forward with surgery. The surgery itself went smoothly, and my recovery has been great. Every member of the staff was kind, professional, and attentive at every visit. I'm so glad I made that first appointment to get evaluated — it's made a real difference in my quality of life. I would give Dr. Nosti and his team a 10/10 recommendation to anyone considering care with this practice.
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Patty Cowan
September 23, 2026
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Latasha Reed was great to work with. She was very thorough and took the time to listen to everything that was going on. She went beyond the scope of the initial reason I was coming to see her and helped me with another concern. I would highly recommend her.
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Shawn Kyndesen
September 11, 2026
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I had my first visit with Kellie James, CRNP and she listened to all my concerns. She gave me a plan to help my urinary in-continuance. She was so easy to talk to! I am so thankful that I saw her. My life has changed for the better! SKK
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charnice burk
September 4, 2026
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Dr. Nosti is great! I felt very confident in his work. He has done 2 procedures for me and both have gone so smooth. He tells you what to expect and has a plan for those things. I would refer him to anyone having gynecological issues that they need surgery for. Thanks Dr. Nosti!!
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Deb Hundley
August 26, 2026
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As a Provider in the region I self referred to Dr. Nosti for female pelvic organ prolapse and stress incontinence. From the time I walked in the door for my initial consult to my post-op surgical follow up the process has been seamless. Any hiccups were anticipated and a plan was in place prior. I’ve been nothing but happy with this process and my results.
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Kathryn Gonzalez
August 26, 2026
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Everyone is so professional and Dr. Nosti is incredible. Surgery went well. I feel more confident.
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Rose Hamilton
August 25, 2026
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This place was amazing, I was treated kindly and softly, everything explained to me as we went, my options and things to help till my next appointment. The office itself is soft, clean, and quiet to help you feel more relaxed in an uncomfortable situation. Everyone was very friendly and respectful. I highly recommend this office. Dr Stork was very friendly, took her time, explained everything and presented my options, pros and cons for each and let me make the choice. She was light-hearted and helped me feel at ease.
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Elaine Smith
August 16, 2026
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Dr Nosti is wonderful, I would recommend him to any of my friends. His office staff are kind, courteous and professional. Highly recommend if you need urogynecology services!!

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