Traditional measures of normal anal sphincter function using high‐resolution anorectal manometry (HRAM) in 115 healthy volunteers

Abstract

The study provides a large healthy volunteer dataset and parameters of traditional measures of anorectal function. A number of novel phenomena are appreciated, the significance of which will require further analysis and comparisons with patient populations.

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

“…22,23,27 Interestingly, anal resting pressure in healthy women was lower in a study from Korea 24 than in different studies from the United States and Europe. 7,22,26 These differences are more likely explained by differences in techniques rather than ethnic differences because anal pressures in healthy Asian volunteers 23,25 were similar to those from a group that included participants from Western countries. 7,22,26 The HR-ARM system (Sandhill Scientific) used in the Korean study 24 averages anal pressures across radial sensors at any level of the catheter.…”

“…7,22,26 These differences are more likely explained by differences in techniques rather than ethnic differences because anal pressures in healthy Asian volunteers 23,25 were similar to those from a group that included participants from Western countries. 7,22,26 The HR-ARM system (Sandhill Scientific) used in the Korean study 24 averages anal pressures across radial sensors at any level of the catheter. This might explain why pressures measured with the Sandhill HR-ARM catheter are lower than those measured with the eSleeve program (Given Imaging HR-ARM and HD-ARM).…”

“…46 Interpreting High-resolution Anorectal Manometry Color Contour Plots Anal pressures and the length of the HPZ can be instantly gauged by visualizing the contour plot at rest. During squeeze, 2 distinct HPZs may be seen 7 ; the upper and lower zones are above and overlap the anal HPZ, and presumably represent contraction of the PRM and EAS, respectively. As noted above, rectal pressure may not increase and anal relaxation may be delayed during simulated evacuation, even in healthy adults.…”

“…7,[22][23][24][25][26][27] However, because the sample size in these studies was relatively small, additional studies are necessary to more precisely define the normal range for anorectal pressures. The interpretation of findings will rely on studies conducted with HRM where available and supplemented by data from studies conducted with non-HRM only when necessary.…”

“…Unisensor catheters (UniTip, Attikon, Switzerland) are comprised of a unidirectional pressure sensor embedded within a soft membrane containing silicone gel. 7 The catheter manufactured by Sandhill has 4 radially-arranged sensors at each level. 8 Water-perfused high resolution catheters (Mui Scientific, Mississauga, Ontario, Canada) are also available.…”