Anorectal testing techniques for fecal incontinence

Anorectal testing techniques for fecal incontinence are used in addition to clinical evaluation. This entails a detailed history, which may be complemented by symptom diaries and self-administered questionnaires, and physical examination. The latter allows for a qualitative assessment of resting tone and squeeze increment, functional anal canal length, perineal descent, perianal sensation, and anocutaneous reflex activity. Anorectal testing techniques for fecal incontinence are presented and assessed for their clinical usefulness. Anorectal manometry in combination with rectal balloon distention tests measures resting tone, voluntary contraction increment, and rectal sensory thresholds. Endoluminal ultrasound has largely replaced EMG mapping for anal sphincter defects, resulting in an increased number of patients amenable to direct surgical repair. Apart from initial diagnosis the described modalities may be used for documentation of any changes over time and during therapy. Tests of nerve and muscle function, and magnetic resonance imaging of the pelvic floor and anal sphincters are currently mainly used for research purposes.