Improving the utility of high‐resolution manometry for the diagnosis of defecatory disorders in women with chronic constipation

Background We compared the utility of existing and modified versions of high‐resolution manometry for diagnosing defecatory disorders (DD). Methods In 64 healthy and 136 constipated women, we compared left lateral (LL) and seated manometry, and analyzed with existing (ManoView™) and new methods, for...

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Veröffentlicht in:Neurogastroenterology and motility 2020-10, Vol.32 (10), p.e13910-n/a
Hauptverfasser: Sharma, Mayank, Muthyala, Anjani, Feuerhak, Kelly, Puthanmadhom Narayanan, Susrutha, Bailey, Kent R., Bharucha, Adil E.
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Sprache:eng
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Zusammenfassung:Background We compared the utility of existing and modified versions of high‐resolution manometry for diagnosing defecatory disorders (DD). Methods In 64 healthy and 136 constipated women, we compared left lateral (LL) and seated manometry, and analyzed with existing (ManoView™) and new methods, for discriminating between constipated patients with normal and prolonged rectal balloon expulsion time (BET). In both positions, the rectoanal gradient (RAG) and, for the new analysis, the pressure topography pattern during evacuation were used to discriminate between constipated patients without and with DD. Key Results The BET was prolonged, suggestive of a DD, in 52 patients (38%). During evacuation, rectoanal pressures and the RAG were greater in the seated than the LL position (P≤.001). The new analysis identified 4 rectoanal pressure patterns. In the seated position, the BET was associated with the pattern (P=.0001), being prolonged in, respectively, 45%, 15%, 53%, and 0% of patients with minimal change, anal relaxation, paradoxical contraction, and transmission. Within each pattern, the RAG was greater (ie, less negative, P
ISSN:1350-1925
1365-2982
DOI:10.1111/nmo.13910