Anorectal Manometry (ARM)
What is ARM?
Anorectal manometry (ARM) is a diagnostic test that evaluates how well your anal and rectal muscles (anorectal sphincter) are working.
These muscles control:
- Stool passage
- Bowel control (continence)
- Coordination during a bowel movement
Think of it as an “EKG for the muscles of the rectum and anus.”
Why Is ARM Performed?
ARM helps identify the cause of symptoms such as:
- Chronic constipation
- Laxative dependence
- Difficulty passing stool
- Fecal incontinence (leakage or smearing)
- Anorectal pain
- Sensation of incomplete evacuation
- Childhood constipation
What Does the Test Measure?
ARM evaluates:
- Rectal sensation
- Muscle strength of the anal sphincter
- Coordination of pelvic floor muscles
- Normal reflexes needed for bowel movements
This helps pinpoint the root cause of symptoms and guide targeted treatment.
How Is the Test Performed?
ARM evaluates:
- A small, flexible catheter (about the size of a thermometer) is gently placed in the rectum
- The catheter has tiny sensors and a small balloon at the tip
- It measures pressure, sensation, and muscle coordination
- You may be asked to:
- Squeeze
- Relax
- Push as if having a bowel movement
The test provides real-time data to understand how your muscles are functioning.
How Do I Prepare for ARM?
Preparation is simple and much easier than a colonoscopy.
- You will use 1–2 Fleet® enemas, which can be purchased at any pharmacy or supermarket
- These should be taken approximately 2 hours before your test
- Do not eat any food during the 2 hours before the procedure
- You may take your regular medications with small sips of water, at least 2 hours prior to the study
If You Have Diabetes
- You may need to adjust your diabetic medications
- Please follow the specific instructions provided by our office or your prescribing physician
How Long Does It Take?
- About 15 minutes
- Quick, simple outpatient test
Will I Be Awake?
Yes.
- No sedation is used
- You are fully awake and alert
- You can talk to the staff during the test
Is It Painful?
- Most patients feel little to no pain
- You may feel mild pressure or brief discomfort
- The procedure is generally very well tolerated
Is It Comfortable?
Yes.
- Quick and minimally invasive
- Small flexible catheter is used
- Performed by trained specialists
- Designed to be as comfortable as possible
Can I Drive Home?
Yes
- No anesthesia or sedation is used
- You may resume normal driving and activities immediately
Results & Clinical Value
ARM helps:
- Identify the exact cause of bowel symptoms
- Guide individualized treatment plans
- Determine if pelvic floor dysfunction is present
- Decide if biofeedback therapy is appropriate
Depending on results, biofeedback therapy may be recommended.
Risks and Safety
ARM is a very safe, low-risk procedure.
- Serious complications are extremely rare
- Overall risk is minimal
- All catheters used are latex-free
Most patients experience no side effects.
Who Should Perform This Test?
ARM is most effective when performed and interpreted by clinicians with specialized motility expertise.
Dr. Sinha has advanced training in GI motility and anorectal disorders, including:
- Training through the American Neurogastroenterology and Motility Society (ANMS)
- Specialized fellowship training under:
- Dr. Henry Parkman
- Dr. Satish Rao (Temple University)
- Advanced experience in complex motility testing and interpretation
Questions Every Patient Should Ask Before Anorectal Manometry (ARM)
Being informed helps you make the best decisions about your healthcare. Before scheduling your procedure, consider asking the following questions:
TOPIC
WHAT YOU SHOULD ASK
WHY IT MATTERS
✔ Complication Rate
How often do you perform ARM? What is your complication rate?
ARM is very safe with extremely low risk.
✔ Awake or Sedated
Will I be awake? Is the test painful?
No sedation is used; mild pressure only.
✔ Preparation
Do I need enemas or fasting? Can I take medications?
Proper prep ensures accurate pressure measurements.
✔ Driving
Can I drive home afterward?
No sedation means immediate return to normal activity
✔ Insurance Coverage
Is ARM covered by insurance?
Coverage depends on diagnosis and medical necessity.
✔ Why It’s Ordered
What condition are you evaluating?
Helps diagnose constipation, incontinence, pelvic floor dysfunction.
An informed patient is empowered to make confident healthcare decisions and to receive the highest-quality care.
If you have any questions or concerns after your procedure, please call:
Hunterdon Digestive Health Specialists
Biofeedback Therapy (If Recommended)
What Is It?
Biofeedback therapy is a first-line treatment for:
- Chronic constipation due to pelvic floor dysfunction
- Fecal incontinence
It retrains the muscles involved in bowel movements.
How It Works
- A small catheter measures muscle activity
- A monitor provides real-time visual feedback
- Patients learn how to properly coordinate pelvic floor muscles
This helps:
- Improve bowel control
- Reduce laxative dependence
- Restore normal muscle coordination
Why It Works
- Up to 50% of patients with chronic constipation have dyssynergic defecation
- This means the pelvic floor muscles do not coordinate properly
- Instead of relaxing, muscles may tighten during bowel movements
Biofeedback retrains this coordination at the source.
Patient Testimonials
Treatment Course
- Typically 4–6 sessions
- Non-invasive
- Minimal discomfort
- No sedation required
How to Prepare
Preparation is simple and does not require any special bowel prep:
- No colonoscopy-style preparation is needed
- You may eat and drink normally unless otherwise instructed
- Take your regular medications as usual
- Wear comfortable clothing to your appointment
What to Expect During Treatment
- A small, soft catheter is placed gently in the rectum
- Sensors measure muscle activity in real time
- A monitor provides visual feedback to help guide exercises
- You will be asked to:
- Squeeze
- Relax
- Push as if having a bowel movement
This helps retrain coordination of the pelvic floor muscles.
Is It Comfortable?
- Yes, most patients find it very tolerable
- The sessions are non-invasive
- Discomfort is usually minimal to none
Will I Be Awake?
- Yes
- No sedation is required
- You remain fully awake and alert during the session
Can I Drive Home?
- Yes
- You may drive yourself to and from appointments
- Normal daily activities can be resumed immediately
How Many Sessions Are Needed?
- Typically 4–6 sessions
- Sessions are scheduled over time based on progress
Is it covered by insurance?
- Covered by most insurance plans
- ARM testing is required prior to personalized treatment
Effectiveness
Biofeedback therapy is strongly supported in medical literature and is considered a first-line treatment for:
- Pelvic floor dysfunction
- Dyssynergic defecation
- Fecal incontinence
Benefits may include:
- Improved bowel control
- Reduced constipation symptoms
- Decreased dependence on laxatives
- Better long-term quality of life
Request Appointment
Contact Us
Our Locations
Find us on the map
Hours of Operation
Our Regular Schedule
Hunterdon Digestive Health Specialists
Monday
8:00 am — 6:00 pm
Tuesday
8:00 am - 7:00 pm
Wednesday
8:00 am - 5:00 pm
Thursday
8:00 am - 6:00 pm
Friday
8:00 am - 7:00 pm
Saturday
*Contact office to confirm Saturday hours and availability*
Sunday
Closed