Anorectal Manometry with 3-D Capability
What is anorectal manometry?
Anorectal manometry is a test that helps us understand how the muscles and nerves in your child’s bottom are working. These muscles, called anal sphincters, help keep stool in and then relax when it is time to have a bowel movement. At Nationwide Children’s Hospital, this test is done by specialists in our Neurogastroenterology and Motility Disorders Center, which focuses on complex problems with how the gut and brain work together.
Doctors recommend anorectal manometry when they need to measure the pressure and movement of the muscles in the rectum and anus. It is most often used for children who have severe constipation, straining or trouble passing stool, stool accidents, or who have had surgery for conditions like Hirschsprung disease or anorectal malformations. The test shows whether the muscles relax at the right time and whether your child can feel stretching in the rectum the way they should. It can also evaluate if the abdominal muscles and the muscles in the bottom are working together or working against each other.
What happens during anorectal manometry?
During the test, your child lies on their side on a bed and parents are present. A small, soft tube (catheter) with a tiny balloon at the tip is gently placed into the rectum using lubricating gel. The tube is connected to a computer. As the balloon is slowly filled with air, the computer measures how the muscles squeeze and relax. Your child may be asked what sensations they feel, to squeeze like they are “holding in poop,” or to push like they are trying to have a bowel movement. They will sit on a bedside commode and try to pass a bowel movement. Most children say the test feels strange but is not painful. There is no cutting or surgery involved, and most children can go home and return to normal activities right after the test.
In infants, a modified version of this test can be done to evaluate for Hirschsprung disease and if inconclusive, a rectal biopsy can be performed in the same encounter.
In some children, a version of this test is performed under anesthesia.
What does 3-D capability mean?
At Nationwide Children’s, our high-resolution anorectal manometry has advanced 3-D capability. This means the tube has many tiny sensors all around it and along its length. These sensors pick up pressure from every side of the anal canal and rectum at the same time. The computer then turns those readings into a highly detailed three-dimensional “map” of pressure, shown in color on the screen.
With 3-D manometry, our providers can see not only how strong the muscles are, but exactly where they may be weak, tight, or not working together. It gives a more complete picture than standard manometry, which uses fewer sensors. For children with complex motility or colorectal problems, this level of detail can make a real difference in diagnosis and treatment planning. But it is not the right test for every patient.
How does this test help my child?
Information from high-resolution anorectal manometry can help your child’s team:
- Confirm or rule out certain conditions that affect the rectum and anus.
- Decide whether surgery is needed or if previous surgery is working as it should.
- Adjust medicines, bowel management plans, or other therapies.
- Plan biofeedback or physical therapy that teach children how to better use their pelvic floor muscles.
Because the test is done in a center that cares only for children and teens, every step is designed with their comfort and safety in mind.
Why choose Nationwide Children’s?
Families travel from across the country and around the world to seek care at Nationwide Children’s Neurogastroenterology and Motility Disorders Center. Our program is recognized as a leader in pediatric gastrointestinal care and advanced motility testing, and the hospital is nationally ranked for gastroenterology and GI surgery. Your child’s care team may include pediatric gastroenterologists, colorectal and pelvic reconstruction surgeons, nurse practitioners, psychologists, dietitians, and child life specialists working together on a personalized plan. We use the latest technology, like 3-D anorectal manometry, along with research-driven treatments to provide clear answers and practical solutions. At Nationwide Children’s, we focus not only on test results, but on helping your child get back to school, friends, and the activities they enjoy.
What Happens During Anorectal Manometry?
During the test, your child lies on their side on a bed and parents are present. A small, soft tube (catheter) with a tiny balloon at the tip is gently placed into the rectum using lubricating gel. The tube is connected to a computer. As the balloon is slowly filled with air, the computer measures how the muscles squeeze and relax. Your child may be asked what sensations they feel, to squeeze like they are “holding in poop,” or to push like they are trying to have a bowel movement. They will sit on a bedside commode and try to pass a bowel movement. Most children say the test feels strange but is not painful. There is no cutting or surgery involved, and most children can go home and return to normal activities right after the test.
In infants, a modified version of this test can be done to evaluate for Hirschsprung disease and if inconclusive, a rectal biopsy can be performed in the same encounter.
In some children, a version of this test is performed under anesthesia.
What Does 3-D Capability Mean?
At Nationwide Children’s, our high-resolution anorectal manometry has advanced 3-D capability. This means the tube has many tiny sensors all around it and along its length. These sensors pick up pressure from every side of the anal canal and rectum at the same time. The computer then turns those readings into a highly detailed three-dimensional “map” of pressure, shown in color on the screen.
With 3-D manometry, our providers can see not only how strong the muscles are, but exactly where they may be weak, tight, or not working together. It gives a more complete picture than standard manometry, which uses fewer sensors. For children with complex motility or colorectal problems, this level of detail can make a real difference in diagnosis and treatment planning. But it is not the right test for every patient.
How Does This Test Help my Child?
Information from high-resolution anorectal manometry can help your child’s team:
- Confirm or rule out certain conditions that affect the rectum and anus.
- Decide whether surgery is needed or if previous surgery is working as it should.
- Adjust medicines, bowel management plans, or other therapies.
- Plan biofeedback or physical therapy that teach children how to better use their pelvic floor muscles.
Because the test is done in a center that cares only for children and teens, every step is designed with their comfort and safety in mind.
Why Choose Nationwide Children’s?
Families travel from across the country and around the world to seek care at Nationwide Children’s Neurogastroenterology and Motility Disorders Center. Our program is recognized as a leader in pediatric gastrointestinal care and advanced motility testing, and the hospital is nationally ranked for gastroenterology and GI surgery. Your child’s care team may include pediatric gastroenterologists, colorectal and pelvic reconstruction surgeons, nurse practitioners, psychologists, dietitians, and child life specialists working together on a personalized plan. We use the latest technology, like 3-D anorectal manometry, along with research-driven treatments to provide clear answers and practical solutions. At Nationwide Children’s, we focus not only on test results, but on helping your child get back to school, friends, and the activities they enjoy.
Medical Reviewer: Peter Lu, MD, Nationwide Children's Hospital
Date Last Reviewed: 2/13/2026
The information provided here is only for general reference and should not take the place of medical care or patient education. If you have any questions, please contact your care team.
