Recto-Anal Coordination This maneuver's goal is to produce a coordinated movement that simultaneously increases the intra abdominal (intra rectal) pressure and relaxes the anal sphincter. First, the patient is educated about their abnormal tracing: A normal pattern is shown and they are encouraged to reproduce this. The patients' posture and breathing are continuously monitored and corrected and verbal reinforcement provided. If a patient consistently demonstrates normal rectoanal coordination, then they are asked to reproduce this without feedback. Approximately 15 bearing down maneuvers are performed at 1 minute intervals, some with and some without rectal balloon distention.