How to Perform and Interpret a High-resolution Anorectal Manometry Test

Lee, Tae Hee; Bharucha, Adil E.

doi:10.5056/jnm15168

Cited by 150 publications

(172 citation statements)

References 54 publications

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“…These maneuvers are indicated to assess the integrity of spinal reflex pathways of the patients; normally, the increased abdominal pressure triggers voluntarily external sphincter contraction. 26 As mentioned above, the complexity of anatomical perineal structures contribute also to the anal tonus. For that reason, voluntary anorectal manometry maneuvers are important for the rationale of biofeedback therapy in patients presenting a severe incontinence due to technically surgical problems.…”

Section: Voluntary Anorectal Manometry Maneuversmentioning

confidence: 99%

“…26 Therefore, a reduced anal resting sphincter pressure could be explained by an anal sphincter deficit, especially in HD patients who underwent a pull-through procedure. In the literature, several authors stated that patients with true incontinence present a significantly lower resting pressure than normal subjects.…”

Section: Anal Resting Pressurementioning

confidence: 99%

“…Although we could not measure rectal compliance in these patients, the maximum tolerated volume indirectly provided helpful information about rectal sensation as well as elasticity and reserve capacity of the neo-rectum. 26 Therefore, the hypothesis is raised that fecal incontinence could be due to rectal factors where the maximum tolerated volume is often impaired and below normal. 32 Here again, technical surgical issues may be of concern.…”

Section: Sensation Testmentioning

confidence: 99%

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Interest of Anorectal Manometry During Long-term Follow-up of Patients Operated on for Hirschsprung's Disease

Tran

Mahler

Bontems

et al. 2018

J Neurogastroenterol Motil

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Background/AimsAlthough many advances in the management of Hirschsprung's disease have recently been achieved, postoperative outcomes of these patients remain difficult in a non-negligible number of cases. Therefore, this study aims at investigating characteristics of anorectal manometry and its relationship with postoperative outcomes during long-term follow-up in Hirschsprung patients. MethodsPatients over 4 years of age operated on for Hirschsprung's disease were interviewed to complete detailed questionnaires on bowel function. The patients who consented to undergo an anorectal manometry during follow-up were enrolled in this study. We investigated their clinical characteristics, manometric findings, and their postoperative bowel function. ResultsNineteen patients out of 53 patients (35.8%) were enrolled, 68.4% who were male. Mean age of patients at manometry was 11.3 ± 6.3 years. Twelve out of 19 patients (63.2%) were incontinent. The mean anal resting pressures of incontinent patients were significantly lower than continent patients (47 ± 12 mmHg versus 63 ± 11 mmHg, P < 0.05, t test). Due to neurological impairment, only 11 patients (57.9%) were able to perform a complete manometry. A dyssynergic defecation was found in 4 patients during strain tests. Maximum tolerated volume of the incontinent patients was significantly lower than that of the continent patients (97 ± 67 mL versus 181 ± 74 mL, P < 0.05, t test). ConclusionAnorectal manometry is an objective method providing useful information that could guide a more adapted management in patients with defecation disorders after Hirschsprung's disease operation.

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Section: Voluntary Anorectal Manometry Maneuversmentioning

confidence: 99%

Section: Anal Resting Pressurementioning

confidence: 99%

Section: Sensation Testmentioning

confidence: 99%

See 1 more Smart Citation

Interest of Anorectal Manometry During Long-term Follow-up of Patients Operated on for Hirschsprung's Disease

Tran

Mahler

Bontems

et al. 2018

J Neurogastroenterol Motil

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“…However, the design of rectal sensors is different from those placed in the anal canal in most catheters. Furthermore, the rectal sensors are generally covered by a non-latex balloon, which impacts on the validity of measurement of rectal pressures [19].…”

Section: What Is High-resolution Anorectal Manometry?mentioning

confidence: 99%

High-Resolution Anorectal Manometry - New Insights in the Diagnostic Assessment of Functional Anorectal Disorders

Heinrich

Misselwitz

2018

Visc Med

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Functional anorectal disorders such as faecal incontinence (FI), functional anorectal pain, and functional defecation disorders (FDD) are highly prevalent and represent a high socioeconomic burden. Several tests of anorectal function exist in this setting; however, high-resolution anorectal manometry (HR-ARM) is a new tool that depicts pressure all along the anal canal and can assess rectoanal coordination. HR-ARM is used in the diagnosis of FI and especially FDD although data in health is still sparse, and pressure phenomena seen during simulated defecation, such as dyssynergia, are highly prevalent in health.

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“…Anorectal manometry (ARM) is used to diagnose defecatory disorders and identify anal weakness in fecal incontinence (FI) (1–3). While high resolution manometry (HRM) catheters provide better spatial resolution, the pressures recorded with ManoscanTM HRM catheters vary over time (4, 5).…”

mentioning

confidence: 99%

Determinants and clinical impact of pressure drift in manoscan anorectal high resolution manometry system

Parthasarathy

McMaster

Feuerhak

et al. 2016

Neurogastroenterology Motil

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Background Pressure drift (PD), resulting from differences between room and body temperature, reduces the accuracy of pressure measurements with the Manoscan high resolution manometry (HRM) system. Our aims were to assess PD during anorectal HRM. Methods Defined as the residual pressure measured immediately after the catheter was removed, PD was calculated for each sensor and averaged across all 12 sensors in 454 anorectal consecutive studies recorded with 3 HRM catheters. The relationship between PD and study duration, number of prior uses of a catheter, and peak and average pressure exposure during a study were evaluated. The correction of PD with a software algorithm (thermal compensation) was evaluated in 76 studies where the most distal sensor was outside the body. Key Results The PD varied among sensors and across catheters. The average PD (7.3±0.2 mm Hg) was significantly greater for newer catheters, during longer studies, or when sensors were exposed to higher pressures. Together, these factors explained 81% of the variance in overall PD. After thermal compensation, the uncorrected median PD for the most distal sensor was 2.5–5 mm Hg over the study duration. Correcting this changed the interpretation (e.g., as abnormal instead of normal) of at least 1 anorectal parameter in 8 of 76 studies. Conclusions & Inferences During anorectal HRM, PD declines with catheter use and is greater for newer catheters, when sensors are exposed to higher pressures, and for studies of longer duration. While PD is partially corrected with thermal compensation algorithms, the impact on interpretation is modest.

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How to Perform and Interpret a High-resolution Anorectal Manometry Test

Cited by 150 publications

References 54 publications

Interest of Anorectal Manometry During Long-term Follow-up of Patients Operated on for Hirschsprung's Disease

Interest of Anorectal Manometry During Long-term Follow-up of Patients Operated on for Hirschsprung's Disease

High-Resolution Anorectal Manometry - New Insights in the Diagnostic Assessment of Functional Anorectal Disorders

Determinants and clinical impact of pressure drift in manoscan anorectal high resolution manometry system

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