In the past week I've had two different tests done to check how my pelvic floor muscles work during a bowel movement. One was an MRI defecogram, and the other was anorectal manometry. Both extremely unpleasant, and I hope to never have to do them again. I'm awaiting the test results and have a followup appointment with the CRS in a few weeks (hopefully sooner) to discuss them.

Patience what led you to having these tests? What are they thinking it might show and how can they help you?
The test sounds horrid you poor thing.
How is pelvic floor therapy going I’ve been twice but I’m having a bad week and wondering if it’s going to work. ??

Just the thought of those kinds of tests makes me shudder! I hope that the results provide you with a new path to follow and a way to get yourself back to good anal health. Keep us posted.

@SueMac- The doctor wants to figure out which muscles aren't working correctly during a BM and causing pain, so that she can decide what treatment plan to follow. It could be Botox or something else. I'm not seeing my PT as often because I've kind of plateaued in terms of progress. I saw her every week for seven weeks and made good progress, so now I see her every 2 weeks. She says my muscles feel relaxed now, so the pain remains a mystery. The manometry nurse mentioned in passing that she feels the sphincter is very tight, but that may have been because the catheter was causing a burning sensation, resulting in tightness. I encourage you to keep up with PT, but it's important to have a short gap between treatments, like a week. Don't be afraid to find a new one if the current one isn't as knowledgeable. There are other forums for pelvic issues where people could recommend a PT in your area. My PT even had my husband come in to a session and explained the problems as well as showed him how to help me with home exercises.

@chachacha: Thanks! I thought the MRI was bad but the manometry was worse. But I think each one was horrible in its own way. Trying to poop out gel while trying not to panic in an MRI tube was certainly a novel experience. Not to mention the alarming thunk-thunk background noises of the machine.

Patience I'm sorry to hear you are still in pain. I really hope this throws out some treatment plan for you. I haven't seen my gp since the specialist discharged me as I'm hoping PT therapy will work. The therapist is very hopeful and I think she's going to be surprised when I go back Tuesday and says I'm no better. I've left a two week gap on her suggestion. She's is over an hours drive so this has suited me. I've only done two sessions. I will keep going for a long while yet before give up. I feel it's my last hope.
Keep us posted on your results!!

Thank you, I hope they can come up with something to help the pain.

Has your PT given you any homework to do in between sessions? If not, that could be why you're not seeing much benefit till now.

I have had both of these unpleasant tests way back with my first fissure. Not nice at all.
At least they are done now. Let us know when you get the results xx

Patience- no she hasn’t really except to keep my pelvis mobile by doing some moves whilst seated.
What kind of homework would it be? Ie there is nothing internal she has asked me to do but she has been doing that at our appointments.
She thinks my pelvis is pulled over on one side and has tried to correct that. It could stop easy bm’s. This could be from a cycling accident 12 years ago but we don’t know. I could see one of her hands was higher than the other and I am crooked. Or so it appears.
She may have helped that with manipulation but in reality all I know is that I still have anal pain after a bm. Maybe in time and with a new diet she’s suggested I won’t .

Homework would be stretching using a dilator. There's one type called the Therawand that allows you to reach trigger points that you wouldn't be able to reach by hand. Has she given a diagnosis of which muscles are tight exactly? As well as an explanation of the 3 layers of the pelvic floor? I found it really helpful to visually see on the pelvic floor model which muscles are tight. I honestly don't think you can make any meaningful progress with 2 weeks between sessions and no homework.

Patience, maybe I need to ask her more when I go back. or maybe see someone's else have another contact I could try. Thanks for the information it's really helpful. I also looked up the wand.
Good luck with your results.