Normal values for high-resolution anorectal manometry in healthy young adults: evidence from Vietnam

Cường, Lê Mạnh; Quyet, Ha Van; Hung, Tran Manh; Anh, Nguyen Ngoc; Ha, Tran Thu; Du, Vu Van; Loi, Do Van; Khai, Ha Huu Hoang; Kien, Vu Duy

doi:10.1186/s12876-021-01865-8

Cited by 8 publications

(6 citation statements)

References 31 publications

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“…Furthermore, our method provided acceptable defecation function. The measurements obtained by manometry, maximum resting pressure, maximum squeeze pressure, and the length of the high-pressure zone yielded similar results compared to reported normal values (9) at two years after surgery. Recovery of the length of the highpressure zone seems to be significantly involved in the noted Wexner score improvements.…”

Section: Discussionsupporting

confidence: 72%

Long-term Outcome of Triple Stapling Resection and J Pouch Anal Stapling Anastomosis for Ulcerative Colitis

Kawahara

Omura

2022

In Vivo

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Background: We previously reported laparoscopic total proctocolectomy with J pouch anal anastomosis, which was created at the dentate line by our original procedure using staplers, Triple Stapling Resection and J pouch Anal Stapling Anastomosis (TSRJASA), for ulcerative colitis (UC) patients. UC patients have undergone TSRJASA since it was introduced in our institution. However, the long-term outcome of TSRJASA for UC patients has not been elucidated. Patients and Methods: From January 2014 to December 2018, fourteen patients with ulcerative colitis, including three cases of concomitant cancer, who underwent TSRJASA were enrolled in this study. Anal manometry was performed using the Pock Monitor GMMS-100 system (STAR MEDICAL, INC., Tokyo, Japan) one and two years after surgery. Maximum resting pressure, maximum squeeze pressure, and the length of the high-pressure zone were measured. Fecal incontinence was evaluated using the Wexner incontinence questionnaire. Results: J pouch anal anastomosis was created at the dentate line in all patients. In a manometric examination two years after surgery, maximum resting pressure was 75.3 (54-88) mm Hg, maximum squeeze pressure was 125.0 (90-160) mm Hg, and the length of the high-pressure zone was 39.6 (35-42) mm. Wexner score was 2.8 (1-4). Conclusion: TSRJASA is a useful procedure for UC patients given its acceptable defecation function.

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Section: Discussionsupporting

confidence: 72%

Long-term Outcome of Triple Stapling Resection and J Pouch Anal Stapling Anastomosis for Ulcerative Colitis

Kawahara

Omura

2022

In Vivo

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“…However, defining "normal" resting and squeeze pressures for ARM values is quite difficult. There is obviously an overlap since several studies showed different values for normal and abnormal resting and squeeze pressures for ARM [14,[23][24][25][26][27][28]. To be accurate in comparing between groups, the pressures should be adjusted according to age, gender, and parous and nulliparous females.…”

Section: Discussionmentioning

confidence: 99%

“…Figures 1 and 2 show examples of the pressure profile during rest (MBP) and during squeeze (MSP) with ManoView. Normal values have been published by several authors and show a large range [14,[23][24][25][26][27][28]. Based on these studies, we considered an anal rest or squeeze pressure lower than 50 mmHg as "low."…”

Section: D High-resolution Anal Manometry (3d-hram)mentioning

confidence: 99%

To what extent are anorectal function tests comparable? A study comparing digital rectal examination, anal electromyography, 3-dimensional high-resolution anal manometry, and transperineal ultrasound

Dekker

Reijn-Baggen

Han-Geurts

et al. 2023

Int J Colorectal Dis

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Background Anorectal function tests are helpful for objective investigation of anorectal (dys)function. A variety of tests are available, but there is no recommendation when to perform which test. Furthermore, which test is the most accurate is controversial and the correlation between these tests is not very clear. The aim of our study was to examine the correlation of anal pressures and the possibility to diagnose pelvic floor dyssynergia between digital rectal examination (DRE) and several anorectal function tests. Methods Between January 2020 and April 2022, all men and women aged 18 to 80 years, treated at the Proctos Clinic, who were referred for pelvic floor physical therapy (PFPT) by the surgeon and underwent anorectal function tests, were included. DRE was performed to establish the anal pressure at rest and during squeeze and straining. Anorectal function tests included 3D high-resolution anal manometry (3D-HRAM), balloon expulsion test (BET), transperineal ultrasound (TPUS), and surface electromyography (s-EMG). Results A total of 50 patients, 37 (74%) females, were included. Median age was 51 years. Twenty-three (62%) females had a history of two or more vaginal deliveries. The most frequent reason for referral for PFPT was fecal incontinence in 27 (54%) patients. The assessed pressures and pelvic floor function measured with DRE by the surgeon and the pelvic floor physical therapist during rest, squeeze, and straining correlated in 78%, 78%, and 84%, respectively. Correlation between DRE and 3D-HRAM or s-EMG was better for squeeze pressures than resting pressures. The correlation between s-EMG and 3D-HRAM was better during squeeze than at rest with an agreement of 59% and 37%, respectively. Conclusion DRE by an experienced investigator is of sufficient value for daily clinical practice to detect dyssynergia and to measure sphincter tone. Commonly performed anorectal function tests correlate poorly with DRE and with other anorectal function tests. When conservative treatment fails, further investigation is warranted; however, these results should be interpreted with caution. What does this paper add to the literature? Anorectal function tests such as the 3D high-resolution anorectal manometry, balloon expulsion test, surface electromyography, and transperineal ultrasound are all frequently performed in the diagnostic workup in patients with defecation disorders. No previous study has compared these tests regarding their outcomes, nor has the interrater agreement been measured regarding the digital rectal examination by two experienced observers. Furthermore, transperineal ultrasound is in all probability not frequently used and therefore underexposed in the diagnostic workup of patients with dyssynergic defecation.

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“…After searching the PubMed database, we have been able to identify few studies which quantify HRAM parameters in the general population, notably the study by Carrington et al [2], Lee et al [3], Deshmukh et al [4] and Le Manh Cuong et al, [5]. All these studies have been conducted on healthy, asymptomatic adults.…”

Section: Introductionmentioning

confidence: 99%

“…All these studies have been conducted on healthy, asymptomatic adults. The number of patients included ranges from 30 [5], to 115 [2]. Because the type of catheter greatly influences the values recorded, a comparison of the normal values reported in these studies is not possible as different types of catheters were used (ISOLAB, Diversatek, Unisensor).…”

Section: Introductionmentioning

confidence: 99%

Normal Values of High Resolution Anorectal Manometry in 132 Romanian Healthy People

Dimitriu,

Saizu,

Oancea

et al. 2023

JGLD

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Background and Aims: The primary method for assessing anorectal function is high resolution anorectal manometry (HRAM). It is a useful tool in the diagnosis of different anorectal functional disorders such as fecal incontinence or dyssynergia. The aim of the present study was to propose a new set of normal values to be used in practice for East-European individuals, as it was proven that the results are highly influenced by race and sociocultural status. Methods: We conducted a study based on anorectal manometric values of healthy volunteers analyzed at Clinic Fundeni Institute, Bucharest, Romania, between 2017 and 2022. The anorectal manometry was performed using a solid-state catheter (Diversatek, 23 pressure sensors). All anorectal measurement values were analyzed using the Bioview Software Analysys, respecting the timing and the order from the standardized IAPWG protocol. Manometric measurements were summarized using mean, median, standard deviation, minimum and maximum values. The impact of age and gender on 8 different manometric parameters was further analyzed. Normal ranges for all numeric variables were estimated using the 5th and 95th percentiles of the measurements. Results: A total of 132 subjects (97 females, 35 males) were enrolled in the study. Median age was similar between groups (54 vs. 55 years). The values for rectal propulsion, anal gradient and anal relaxation proved to be higher in females under 54 years as opposed to older women. The values for resting pressure, maximum squeeze pressure, incremental squeeze pressure were significantly higher in males younger than 54. Regardless of age, values for maximum squeeze pressure, incremental squeeze pressure, duration of squeeze and rectal propulsion were found to be significantly higher in males than in females. Normal values of HRAM in healthy volunteers are presented in a table at the end of the study. Conclusions: The data presented in the current study are of high value and have a great impact on clinical practice, being the first study offering a spectrum of the normal values for HRAM in an Eastern Europe population.

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Normal values for high-resolution anorectal manometry in healthy young adults: evidence from Vietnam

Cited by 8 publications

References 31 publications

Long-term Outcome of Triple Stapling Resection and J Pouch Anal Stapling Anastomosis for Ulcerative Colitis

Long-term Outcome of Triple Stapling Resection and J Pouch Anal Stapling Anastomosis for Ulcerative Colitis

To what extent are anorectal function tests comparable? A study comparing digital rectal examination, anal electromyography, 3-dimensional high-resolution anal manometry, and transperineal ultrasound

Normal Values of High Resolution Anorectal Manometry in 132 Romanian Healthy People

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