Motility Testing of the Intestine

Motor disorders of the small intestine, colon and anorectum are common and present significant diagnostic and therapeutic challenges for the clinician. A plethora of tests have been developed and advocated to aid in diagnosis and guide the management of these disorders. Few have been subjected to rigorous objective assessment in terms of their true impact on patient outcome. Some and especially the more complex and invasive methodologies, such as small intestinal or colonic manometry, are available only at a few highly specialized centers. In terms of clinical utility, a normal small intestinal manometry may prove of critical value, in the appropriate context, in directing patient management and studies of colon transit, which are relatively easy to perform and widely available, can define slow-transit constipation and anorectal manometry and an endo-anal study of sphincter morphology provide valuable information in the context of fecal incontinence. On the other hand, a variety of techniques are available for the assessment of ano-rectal and pelvic floor function; the clinician should select tests based on both evidence of their impact and available local expertise.