Anorectal Manometry in Defecatory Disorders: A Comparative Analysis of High-resolution Pressure Topography and Waveform Manometry

Yeong Yeh Lee; Askin Erdogan; Siegfried Yu; Annie Dewitt; Satish S C Rao

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저자정보: Yeong Yeh Lee (Section of Gastroenterology and Hepatology Augusta University Augusta GA USA) Askin Erdogan (Section of Gastroenterology and Hepatology Augusta University Augusta GA USA) Siegfried Yu (Section of Gastroenterology and Hepatology Augusta University Augusta GA USA) Annie Dewitt (Section of Gastroenterology and Hepatology Augusta University Augusta GA USA) Satish S C Rao (Section of Gastroenterology and Hepatology Augusta University Augusta GA USA)

저널정보: 대한소화관운동학회(현 대한소화기능성질환.운동학회) Journal of Neurogastroenterology and Motility (JNM) Journal of Neurogastroenterology and Motility (JNM) Vol.24 No.3

발행연도: 2018.1

수록면: 460 - 468 (9page)

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Background/Aims Whether high-resolution anorectal pressure topography (HRPT), having better fidelity and spatio-temporal resolution is comparable to waveform manometry (WM) in the diagnosis and characterization of defecatory disorders (DD) is not known. Methods Patients with chronic constipation (Rome III) were evaluated for DD with HRPT and WM during bearing-down “on-bed” without inflated rectal balloon and “on-commode (toilet)” with 60-mL inflated rectal balloon. Eleven healthy volunteers were also evaluated. Results Ninety-three of 117 screened participants (F/M = 77/16) were included. Balloon expulsion time was abnormal (> 60 seconds) in 56% (mean 214.4 seconds). A modest correlation between HRPT and WM was observed for sphincter length (R = 0.4) and likewise agreement between dyssynergic subtypes (κ = 0.4). During bearing down, 2 or more anal pressure-segments (distal and proximal) could be appreciated and their expansion measured with HRPT but not WM. In constipated vs healthy participants, the proximal segment was more expanded (2.0 cm vs 1.0 cm, P = 0.003) and of greater pressure (94.8 mmHg vs 54.0 mmHg, P = 0.010) during bearing down on-commode but not on-bed. Conclusions Because of its better resolution, HRPT may identify more structural and functional abnormalities including puborectal dysfunction (proximal expansion) than WM. Bearing down on-commode with an inflated rectal balloon may provide additional dimension in characterizing DD.

참고문헌 (22)

참고문헌 신청

Bharucha AE / 2014 / An update on anorectal disorders for gastroenterologists / Gastroenterology 146:37~45

Lee YY / 2013 / High resolution and high definition anorectal manometry and pressure topography: diagnostic advance or a new kid on the block? / Curr Gastroenterol Rep 15:360

Rao SSC / 2004 / Investigation of the utility of colorectal function tests and Rome II criteria in dyssynergic defecation (Anismus) / Neurogastroenterol Motil 16:589~596

Rao SSC / 2010 / Clinical utility of colonic and anorectal manometry in chronic constipation / J Clin Gastroenterol 44:597~609

Ratuapli SK / 2013 / Phenotypic identification and classification of functional defecatory disorders using high-resolution anorectal manometry / Gastroenterology 144:314~322

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