There are two small muscles in the anus (opening from the rectum) that help to control bowel movements. These muscles are known as internal and external sphincters (sfink-ters). (Figures 1 and 2)

These muscles are normally closed to prevent uncontrolled leakage of bowel movements. To have a bowel movement, these muscles must relax and open at the same time. Anal manometry is a test that studies how these muscles are working.

Before the Test

• Explain to your child how the test is done at a time that you feel is best. The nurse will help you with this.
• You will be instructed how and when to give your child an enema or suppository before the test.
• It may be helpful to bring a favorite toy to make your child more comfortable during the procedure.

During the Test

• You will be instructed where to register for the test. Someone will bring or direct you to the location for the test.
• The nurses may wear gowns, gloves and plastic glasses.
• Your child will need to take off his/her pants and underwear. He/she will be asked to lie on his/her left side on the table (Figure 3). It is important that your child lie still during the test.
• A tube with a balloon is inserted into the rectum. (Figure 4) The balloon is slowly inflated to different sizes.
• The tube is connected to a computer with a graph. The computer records how well the muscles around the anus are working.
• During the test, parents may be with their child or wait in the waiting area.
• The test will take about 45 minutes.

What Your Child Will Experience

• The amount of air in the balloon is increased and decreased several times during the test. When the air is increased, your child will feel like he/she has to have a bowel movement. This urge will last only a few seconds and will go away as soon as the amount of air in the balloon is changed.
• An older child may be asked to tell the nurse what he/she feels during the test.

After the Test

• Your child may return to a normal diet, play and usual activities.
• Your child's doctor will discuss the results of the test with you in about one to two weeks.