MRI proctogram

An MRI proctogram is a specialised imaging test used to assess the function of the pelvic floor and rectum during bowel movements. It provides detailed images of the muscles, ligaments, and organs in the pelvic area and helps identify problems with how the bowel is emptying.

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This scan is particularly useful for diagnosing conditions such as:

• Rectal prolapse (where the rectum slips down or out of place)

• Obstructed defaecation syndrome (difficulty emptying the bowels)

• Enterocele (when part of the small intestine pushes into the vaginal wall)

• Rectocele (a bulging of the rectum into the vaginal wall)

• Faecal incontinence (loss of bowel control)

• Pelvic floor dysfunction (weak or uncoordinated pelvic muscles)

 

Unlike other MRI scans, an MRI proctogram captures images while you are straining or trying to empty your bowels, providing essential information about how your pelvic floor functions.

 

Why might you need an MRI proctogram?

Your doctor may recommend an MRI proctogram if you have:

• Chronic constipation or difficulty passing stool

• The sensation of incomplete emptying after using the toilet

• A feeling of pressure or bulging in the rectum or vagina

• Unexplained pelvic pain or discomfort

• Faecal leakage or incontinence

• A known or suspected rectal prolapse

 

This scan helps diagnose the cause of these symptoms and guides treatment decisions, including whether surgery may be needed.

 

How to prepare for the scan

Your radiology team will provide specific instructions before your scan, but general preparation includes:

• Fasting – You may need to avoid food and drink for at least 4–6 hours before the procedure

• Bowel preparation – You may be given an enema before the scan to ensure the rectum is clear

• Clothing – You will need to remove metal objects such as jewellery, belts, or hearing aids

• Medications – Let your doctor know if you are taking any medicines that affect your bowel movements

 

What happens during the scan?

 

Preparing for the scan

• You will be asked to change into a hospital gown

• A small amount of gel (contrast material) will be placed into your rectum using a small tube. This mimics stool and allows the MRI to track how your bowel moves

• In some cases, additional contrast may be given through a vein to enhance imaging

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MRI imaging

• You will lie on the MRI scanning table, which will move into the MRI machine

• The scanner makes loud tapping noises, so you will be given earplugs or headphones

• You will be asked to contract, relax, and push as if you were trying to empty your bowels while the MRI captures images

• The scan usually takes 20 to 40 minutes

 

Are there any risks?

MRI proctograms are very safe, but you should be aware of:

• Mild discomfort – The rectal gel may feel unusual, but it is harmless and will pass naturally

• Claustrophobia – If you feel anxious in small spaces, let the team know before the scan

• MRI safety concerns – If you have a pacemaker, cochlear implant, or metal implants, inform the radiology team beforehand

 

What happens after the scan?

• You can return to normal activities immediately after the scan

• You may notice some contrast gel passing naturally when you next go to the toilet

• Your consultant will review the images, and results will be discussed at your follow-up appointment