Defecography (also known as proctography) is a radiologic test where medical x-rays are used to show the function of the pelvic floor during defecation. Images are recorded of the rectum and surrounding organs and these can be analyzed by a radiologist to understand disorders of anorectal function.
At The Ottawa Hospital this test is carried out in a special fluoroscopy room with the patient in a seated position. Similar examinations sometimes described in a magnetic resonance scanner (MRI) would not allow the normal seated posture and are not carried out at our hospital.
Defecography may be indicated for the following reasons:
- Evaluation of rectal outlet obstruction (obstructed defecation) symptoms
- Suspected conditions such internal rectal intussusception, enterocele, anismus, rectocele or sigmoidocele
- To compare pre- and post-surgical repair of rectal outlet obstruction (obstructed defecation)
When you arrive on the day of the test you will be asked to drink 1 cup of barium liquid to fill your small bowel about 1.5 hours prior to the actual procedure.
After the exam is explained to you, you will be asked to lie on your side by the physician (radiologist) performing the procedure.
The technique begins with (in female patients) the insertion of a tiny catheter into the vagina by the radiologist where a small amount of barium is injected. This is completely safe and has no risks.
Following this, a catheter is inserted into the rectum by the radiologist with subsequent insertion of barium suspension until there is adequate distension creating the urge to defecate. One may experience some cramping during this portion of the test but this is normal and usually very mild. It is also normal to hear “popping” or “gurgling” sounds as the gas within the colon is displaced.
You will then be transferred to a portable plastic commode which is situated next to a fluoroscope which records the defecation.
At this point several images are recorded in order to complete the test. The lights will be turned off so that you will have some privacy and the radiologist can observe the anatomy and function of the rectum and pelvic floor with the fluoroscope.
No bowel preparation is required for this examination.