New developments in defecatory studies based on biomechatronics

Gregersen, Hans; Sun, Dihua; Chen, S.C.; Leung, Wing Wa; Wong, Carlos K. H.; Mak, Terrence; Ng, Simon; Futaba, Kaori; Lo, Kar Man; Kassab, Ghassan S.

doi:10.1016/j.jare.2021.05.005

Cited by 8 publications

(14 citation statements)

References 34 publications

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“…Multiple parameters were calculated including the questionnaire scores, duration of the whole experiment, expulsion duration, bending angles, pressure amplitudes, expulsion velocity, and preload‐afterload pressure plots (Chen et al, 2021a, 2021b; Gregersen, 2020; Gregersen et al, 2019; Gregersen, Chen, et al, 2021; Gregersen, Sun, et al, 2021; Kassab et al, 2021; Takeuchi et al, 2003). The expulsion velocity was derived from the color (diameter) topographies when the device was half evacuated.…”

Section: Methodsmentioning

confidence: 99%

“…The basic design of the previous Fecobionics prototype has been previously described (Chen et al, 2020; Gregersen, 2020; Gregersen, Sun, et al, 2021; Kassab et al, 2021; Sun et al, 2019). Previous versions recorded pressures only or did not have an integrated graphical user interface.…”

Section: Methodsmentioning

confidence: 99%

“…The preload‐afterload diagram plots the front pressure as a function of the rear pressure. It is a novel way to express Fecobionics data (Gregersen, 2020; Gregersen, Sun, et al, 2021; Kassab et al, 2021), which relates to the RAPG. For defecation, the rectum or abdominal muscle contractions generate the preload whereas the afterload is due to anal resistance.…”

Section: Methodsmentioning

confidence: 99%

“…Other studies have been done on patients with FI including patients with low anterior resection syndrome (LARS) and CC including obstructed defecators (Chen et al, 2021b; Gregersen et al, 2020; Gregersen, Chen, et al, 2021). Furthermore, pilot studies have been done with an early stage integrated Fecobionics prototype in colon and anorectum (Gregersen, 2020; Gregersen, Sun, et al, 2021; Gregersen, Wang, et al, 2021; Kassab et al, 2021; Sun et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

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Feasibility study of defecation studied with a wireless Fecobionics probe in normal subjects

Gregersen

Wang

Field³

et al. 2022

Physiological Reports

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Several technologies have been developed for assessing anorectal function including the act of defecation. We used a new prototype of the Fecobionics technology, a multi-sensor simulated feces, to visualize defecatory patterns and introduced new metrics for anorectal physiology assessment in normal subjects. Fourteen subjects with normal fecal incontinence and constipation questionnaire scores were studied. The 10-cm-long Fecobionics device provided measurements of axial pressures, orientation, bending, and shape. The Fecobionics bag was distended to the urge-to-defecate level inside rectum where after the subjects were asked to evacuate. Physiological evacuation parameters were assessed. Special attention was paid to the Fecobionics rectoanal pressure gradient (F-RAPG) during evacuation. Anorectal manometry (ARM) and balloon expulsion test (BET) were done as references. The user interface displayed the fine coordination between pressures, orientation, bending angle, and shape. The pressures showed that Fecobionics was expelled in 11.5 s (quartiles 7.5 and 18.8s), which was shorter than the subjectively reported expulsion time of the BET balloon. Six subjects did not expel the BET balloon within 2 min. The F-RAPG was 101 (79-131) cmH 2 O, whereas the ARM-RAPG was −28 (−5 to −47) cmH 2 0 (p < 0.001). There was no association between the two RAPGs (r 2 = 0.19). Fecobionics showed paradoxical contractions in one subject (7%) compared to 12 subjects with ARM (86%). Fecobionics obtained novel physiological data. Defecatory patterns and data are reported and can be used to guide larger-scale studies in normal subjects and patients with defecatory disorders. In accordance with other studies, this Fecobionics study questions the value of the ARM-RAPG.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Feasibility study of defecation studied with a wireless Fecobionics probe in normal subjects

Gregersen

Wang

Field³

et al. 2022

Physiological Reports

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, large-scale studies are required to further assess subtype phenotypes and treatment effects. Future studies may take advantage of improved wireless devices that in addition can measure the anorectal angle and the bag shape (38)(39)(40)(41)(42). Future studies may also examine the efficacy of Fecobionics as a therapeutic tool for performing biofeedback treatment in FI patients.…”

Section: Pathophysiological Aspectsmentioning

confidence: 99%

Fecobionics Evaluation of Biofeedback Therapy in Patients With Fecal Incontinence

Futaba

Chen

Leung

et al. 2022

Clin Transl Gastroenterol

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INTRODUCTION: Biofeedback therapy (BFT) is a well-known treatment for functional anorectal disorders. The effect of BFT was monitored in fecal incontinence (FI) patients with the Fecobionics test and with the conventional technologies, anorectal manometry (ARM) and balloon expulsion test (BET). METHODS:Studies were performed in 12 patients before and after 8 weeks of biofeedback training. The Fecal Incontinence Severity Index (FISI) score was obtained. Anal resting and squeeze pressures were measured before the bag was distended in the rectum until urge to defecate. Pressure recordings were made during Fecobionics evacuation. RESULTS:BFT resulted in 24% reduction in FISI scores (P < 0.01). Seven patients were characterized as responders. Anal pressures, the urge-to-defecate volume, and defecatory parameters did not change significantly during BFT. For ARM-BET, the maximum anal squeeze pressure, the urge-to-defecate volume, and the expulsion time were lower after BFT compared with those before BFT (P < 0.05).For Fecobionics, the change in urge volume (r 5 0.74, P < 0.05) and the change in defecation index (r 5 0.79, P < 0.01) were associated with the change in FISI score. None of the ARM-BET parameters were associated with the change in FISI score. It was studied whether any pre-BFT data could predict treatment success. The Fecobionics expulsion duration and the defecation index predicted the outcome (P < 0.05). The defecation index had a sensitivity of 100% and a specificity of 72%. None of the ARM-BET parameters predicted the outcome (all P > 0.2). DISCUSSION:Fecobionics was used as a tool to monitor the effect of BFT and proved better than conventional technologies for monitoring and predicting the outcome in the FISI score.

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Anorectal volume–pressure relations, contraction work, and flow during defecation

Gregersen

Wang

Field³

et al. 2022

Biomech Model Mechanobiol

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New developments in defecatory studies based on biomechatronics

Cited by 8 publications

References 34 publications

Feasibility study of defecation studied with a wireless Fecobionics probe in normal subjects

Feasibility study of defecation studied with a wireless Fecobionics probe in normal subjects

Fecobionics Evaluation of Biofeedback Therapy in Patients With Fecal Incontinence

Anorectal volume–pressure relations, contraction work, and flow during defecation

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