Anorectal Manometry in Defecatory Disorders: A Comparative Analysis of High-resolution Pressure Topography and Waveform Manometry
| Autor: | Askin Erdogan, Annie Dewitt, Siegfried Yu, Yeong Yeh Lee, Satish S.C. Rao |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Constipation
Manometry Balloon 03 medical and health sciences 0302 clinical medicine medicine Defecation Chronic constipation Gastrointestinal motility business.industry Anorectal manometry Gastroenterology Anal canal medicine.anatomical_structure 030220 oncology & carcinogenesis Sphincter Original Article 030211 gastroenterology & hepatology Neurology (clinical) medicine.symptom Rectal Balloon Nuclear medicine business |
| Zdroj: | Scopus-Elsevier Journal of Neurogastroenterology and Motility |
| ISSN: | 2093-0887 2093-0879 |
| Popis: | Background/Aims Whether high-resolution anorectal pressure topography (HRPT), having better fidelity and spatio-temporal resolution is comparable to waveform manometry (WM) in the diagnosis and characterization of defecatory disorders (DD) is not known. Methods Patients with chronic constipation (Rome III) were evaluated for DD with HRPT and WM during bearing-down “on-bed” without inflated rectal balloon and “on-commode (toilet)” with 60-mL inflated rectal balloon. Eleven healthy volunteers were also evaluated. Results Ninety-three of 117 screened participants (F/M = 77/16) were included. Balloon expulsion time was abnormal (> 60 seconds) in 56% (mean 214.4 seconds). A modest correlation between HRPT and WM was observed for sphincter length (R = 0.4) and likewise agreement between dyssynergic subtypes (κ = 0.4). During bearing down, 2 or more anal pressure-segments (distal and proximal) could be appreciated and their expansion measured with HRPT but not WM. In constipated vs healthy participants, the proximal segment was more expanded (2.0 cm vs 1.0 cm, P = 0.003) and of greater pressure (94.8 mmHg vs 54.0 mmHg, P = 0.010) during bearing down on-commode but not on-bed. Conclusions Because of its better resolution, HRPT may identify more structural and functional abnormalities including puborectal dysfunction (proximal expansion) than WM. Bearing down on-commode with an inflated rectal balloon may provide additional dimension in characterizing DD. |
| Databáze: | OpenAIRE |
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