Normal Values of High-resolution Anorectal Manometry of Healthy Indians

Deshmukh, Rahul; Shukla, Akash; Chandnani, Sanjay; Rathi, Pravin; Tibdewal, Pratik; Jain, Shubham; Ramani, Nitin; Junare, Parmeshwar; Debnath, P. K.; Shinde, Leela; Bagwan, Asif; Meshram, Megha

doi:10.5056/jnm21107

Cited by 6 publications

(3 citation statements)

References 85 publications

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“…The comparison of water-perfused HRM manometric parameters studies [19][20][21] by gender and separated by analyzes (rest, squeeze, cough, push, rectal sensory thresholds, and RAIR) are depicted in Table 6.…”

Section: Studies Comparison Of Healthy Volunteers Under Perfusional H...mentioning

confidence: 99%

London Protocol under water-perfused HRM in a healthy population, towards novel 3D manometric parameters in an evaluation of anorectal functional disorders

Anefalos,

Martinez,

Coy

2024

BMC Gastroenterol

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Background/Aim London Protocol (LP) and Classification allied to high-resolution manometry (HRM) technological evolution has updated and enhanced the diagnostic armamentarium in anorectal disorders. This study aims to evaluate LP reproducibility under water-perfused HRM, provide normal data and new parameters based on 3D and healthy comparison studies under perfusional HRM. Methods Fifty healthy (25 F) underwent water-perfused 36 channel HRM based on LP at resting, squeeze, cough, push, and rectal sensory. Additional 3D manometric parameters were: pressure-volume (PV) 104mmHg2.cm (resting, short and long squeeze, cough); highest and lowest pressure asymmetry (resting, short squeeze, and cough). Complementary parameters (CP) were: resting (mean pressure, functional anal canal length); short squeeze (mean and maximum absolute squeeze pressure), endurance (fatigue rate, fatigue rate index, capacity to sustain); cough (anorectal gradient pressure); push (rectum-anal gradient pressure, anal canal relaxation percent); recto-anal inhibitory reflex (anal canal relaxation percent). Results No difference to genders: resting (LP, CP, and 3D); short squeeze (highest pressure asymmetry); endurance (CP); cough (CP, highest and lowest pressure asymmetry); push (gradient pressure); rectal sensory. Higher pressure in men: short squeeze (maximum incremental, absolute, and mean pressure, PV, lowest pressure asymmetry); long squeeze (PV); cough (anal canal and rectum maximum pressure, anal canal PV); push (anal canal and rectum maximum pressure). Anal canal relaxation was higher in women (push). Conclusions LP reproducibility is feasible under water-perfused HRM, and comparative studies could bring similarity to dataset expansion. Novel 3D parameters need further studies with healthy and larger data to be validated and for disease comparisons. Key points • London Protocol and Classification allied with the technological evolution of HRM (software and probes) has refined the diagnostic armamentarium in anorectal disorders. • Novel 3D and deepening the analysis of manometric parameters before the London Classification as a contributory diagnostic tool. • Comparison of healthy volunteers according to the London Protocol under a perfusional high-resolution system could establish equivalence points.

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Section: Studies Comparison Of Healthy Volunteers Under Perfusional H...mentioning

confidence: 99%

London Protocol under water-perfused HRM in a healthy population, towards novel 3D manometric parameters in an evaluation of anorectal functional disorders

Anefalos,

Martinez,

Coy

2024

BMC Gastroenterol

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“…62 High-resolution ARM has enabled data acquisition of a high spatial resolution and continuous visualization of the anorectal pressure activity. 63,64 High-resolution ARM is currently performed in more than 50% of all gastrointestinal motility laboratories worldwide 65 and is well correlated with traditional ARM. 66 However, there are significant discrepancies among the methods of data acquisition, analysis, and interpretation using ARM.…”

Section: Anorectal Manometrymentioning

confidence: 99%

2022 Seoul Consensus on Clinical Practice Guidelines for Functional Constipation

Cho

Lee

Shin

et al. 2023

J Neurogastroenterol Motil

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Chronic constipation is one of the most common digestive diseases encountered in clinical practice. Constipation manifests as a variety of symptoms, such as infrequent bowel movements, hard stools, feeling of incomplete evacuation, straining at defecation, a sense of anorectal blockage during defecation, and use of digital maneuvers to assist defecation. During the diagnosis of chronic constipation, the Bristol Stool Form Scale, colonoscopy, and a digital rectal examination are useful for objective symptom evaluation and differential diagnosis of secondary constipation. Physiological tests for functional constipation have complementary roles and are recommended for patients who have failed to respond to treatment with available laxatives and those who are strongly suspected of having a defecatory disorder. As new evidence on the diagnosis and management of functional constipation emerged, the need to revise the previous guideline was suggested. Therefore, these evidence-based guidelines have proposed recommendations developed using a systematic review and meta-analysis of the treatment options available for functional constipation. The benefits and cautions of new pharmacological agents (such as lubiprostone and linaclotide) and conventional laxatives have been described through a meta-analysis. The guidelines consist of 34 recommendations, including 3 concerning the definition and epidemiology of functional constipation, 9 regarding diagnoses, and 22 regarding managements. Clinicians (including primary physicians, general health professionals, medical students, residents, and other healthcare professionals) and patients can refer to these guidelines to make informed decisions regarding the management of functional constipation.

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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%

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 of High-resolution Anorectal Manometry of Healthy Indians

Cited by 6 publications

References 85 publications

London Protocol under water-perfused HRM in a healthy population, towards novel 3D manometric parameters in an evaluation of anorectal functional disorders

London Protocol under water-perfused HRM in a healthy population, towards novel 3D manometric parameters in an evaluation of anorectal functional disorders

2022 Seoul Consensus on Clinical Practice Guidelines for Functional Constipation

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

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