Distensibility of the anal canal in patients with systemic sclerosis: a study with the functional lumen imaging probe

Fynne, Lotte; Luft, F.; Gregersen, Hans; Buntzen, Steen; Lundby, Lilli; Lundager, Flemming Holbæk; Laurberg, Søren; Krogh, Klaus

doi:10.1111/codi.12063

Cited by 31 publications

(58 citation statements)

References 26 publications

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“…The resistance to distension in the middle part was reduced in fecal incontinence patients, and the reduction was intensified with greater distension. In patients with systemic sclerosis, the middle part, representing the internal anal sphincter, was also the most resistant [57]. Compared with healthy controls, however, the distensibility in patients with systemic sclerosis was clearly increased (Fig.…”

Section: Anal Sphinctersmentioning

confidence: 93%

“…So far, only four studies have been published [54][55][56][57]. In vitro tests have shown FLIP distensibility measurements to have great validity and reproducibility [54].…”

Section: Anal Sphinctersmentioning

confidence: 99%

“…The FLIP study demonstrated consistent distension profiles in all 20 volunteers. Two studies evaluated the dynamic properties in the anal canal in patients with fecal incontinence [56,57]. Comparing idiopathic fecal incontinence patients with healthy controls showed that the distensibility properties vary with the degree of distension [56].…”

Section: Anal Sphinctersmentioning

confidence: 99%

“…Figure 7 shows a simple diagram of pressure versus stretch ratio for three locations in the anal sphincter. Studies done with the FLIP demonstrate the nonlinear pressure (tension)-deformation relationships of GI sphincters [33,54,57,68]. Often the pressure is observed to increase during the beginning of the measurement without much distension of the sphincter, but at some point, which may be termed the ''opening pressure,'' the sphincter starts to yield, after which it becomes much more compliant until a certain point.…”

Section: Limitations and Flip-measurement-based Biomechanical Assessmentmentioning

confidence: 99%

“…In most of the studies published, the distensibility is evaluated in terms of very simple measures such as simply looking at the magnitude of the CSA or dividing the CSA by the pressure at a given point of distension [33,54,57]. This may easily introduce errors.…”

Section: Limitations and Flip-measurement-based Biomechanical Assessmentmentioning

confidence: 99%

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Functional lumen imaging of the gastrointestinal tract

et al. 2015

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This nonsystematic review aims to describe recent developments in the use of functional lumen imaging in the gastrointestinal tract stimulated by the introduction of the functional lumen imaging probe. When ingested food in liquid and solid form is transported along the gastrointestinal tract, sphincters provide an important role in the flow and control of these contents. Inadequate function of sphincters is the basis of many gastrointestinal diseases. Despite this, traditional methods of sphincter diagnosis and measurement such as fluoroscopy, manometry, and the barostat are limited in what they can tell us. It has long been thought that measurement of sphincter function through resistance to distension is a better approach, now more commonly known as distensibility testing. The functional lumen imaging probe is the first medical measurement device that purports in a practical way to provide geometric profiling and measurement of distensibility in sphincters. With use of impedance planimetry, an axial series of cross-sectional areas and pressure in a cathetermounted allantoid bag are used for the calculation of distensibility parameters. The technique has been trialed in many valvular areas of the gastrointestinal tract, including the upper esophageal sphincter, the esophagogastric junction, and the anorectal region. It has shown potential in the biomechanical assessment of sphincter function and characterization of swallowing disorders, gastroesophageal reflux disease, eosinophilic esophagitis, achalasia, and fecal incontinence. From this early work, the functional lumen imaging technique has the potential to contribute to a better and more physiological understanding of narrowing regions in the gastrointestinal tract in general and sphincters in particular.

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Section: Anal Sphinctersmentioning

confidence: 93%

“…So far, only four studies have been published [54][55][56][57]. In vitro tests have shown FLIP distensibility measurements to have great validity and reproducibility [54].…”

Section: Anal Sphinctersmentioning

confidence: 99%