Abstract
Anorectal disorders (ADs) with symptoms of fecal incontinence (FI) and impaired evacuation are highly prevalent and represent a significant socio-economic burden. Symptoms alone do not provide sufficient information on the underlying pathology, therefore in cases where symptoms are refractory to treatment anorectal testing is indicated. The continence mechanism is complex and requires a complex interaction of involuntary and voluntary muscle activity, motor and sensory motor pathways, as well as a functioning rectal reservoir. The armamentarium of diagnostic tools in ADs has grown over recent years to include high-resolution anorectal manometry, EndoFLIP for the assessment of anal distensibility, and novel imaging technologies, such as magnetic resonance imaging. These innovations have improved our understanding of anorectal structure and function. However, no single test can diagnose FI and an evacuatory disorder on its own and current guidelines recommend a series of tests to assess anorectal structure as well as sensory and motor function.
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