Toward more accurate measurements of anorectal motor and sensory function in routine clinical practice: Validation of High‐Resolution Anorectal Manometry and Rapid Barostat Bag measurements of rectal function

Abstract

HR-ARM with RBB measurements of anorectal function provides quick and reasonably accurate measurements of continence function suitable for use in routine clinical practice (ClinicalTrial.gov NCT01456442).

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

“…However, recent observations with esophageal ManoScan catheters suggest that this pressure drift is related to "average pressure exposure" of a sensor during the study procedure and may not be adequately corrected with the thermal compensation algorithm. 14 In addition, while pressures recorded with HR-ARM and non-high resolution manometry are significantly correlated, [9][10][11]15 anal sphincter pressures at rest and during anal contraction (ie, squeeze maneuver) tend to be higher when measured with HR-ARM than when measured with non-high resolution manometry. [9][10][11] The rectoanal pressure gradient measured with both techniques was also strongly correlated; however the gradient was more negative for non-high resolution (-66 mmHg) than HR-ARM, 10 even in healthy women.…”

“…HR-ARM measurements of anal sphincter pressures at rest and during squeeze are higher than the corresponding pressures recorded with non-high resolution manometry because of the eSleeve function, which uses the highest pressures recorded at any level of the anal canal at every instant in time. 10 Sandhill high-resolution anorectal manometry system…”

“…HR-ARM and HD-ARM catheters provide a continuous and dynamic spatiotemporal mapping of anorectal pressures, allowing easier and more detailed data interpretation. [9][10][11][12] While HR-ARM and HD-ARM both measure pressures around the circumference of the catheter, only HD-ARM provides the pressures measured by individual sensors around the catheter circumference. 12,13 The duration of the examination is also significantly shorter with HR-ARM than with non-HRM because the former does not require a pull-through procedure, and the topographic display enables rapid positioning of the probe.…”

“…12,13 The duration of the examination is also significantly shorter with HR-ARM than with non-HRM because the former does not require a pull-through procedure, and the topographic display enables rapid positioning of the probe. 10,11 However, HR-ARM and HD-ARM catheters are more expensive and fragile than non-high resolution catheters and have a shorter lifespan. 12 For example, ManoScan catheters are guaranteed for 200 uses only.…”

Efficacy and Predictors for Biofeedback Therapeutic Outcome in Patients with Dyssynergic Defecation

“…The rectal balloon, with the attached catheter, was placed 3 cm proximal to the upper part of the anal sphincter. Measurements were made in the following order: resting anal and rectal pressure (20-30 seconds), pressure during squeeze (best of three attempts, with a maximum duration of 20-30 seconds per attempt), and pressure during bearing down as in defecation (best of three attempts, with 20-30 seconds per attempt) [34]. Rectal sensation was simultaneously evaluated; for this, the rectal balloon was progressively distended in 10 mL increments from 0 mL to 50 mL, and threshold volumes for first sensation, urgency, and maximum discomfort were recorded.…”