ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2017
High-resolution Anorectal Manometry for Identifying Defecatory Disorders and Rectal Structural Abnormalities in Women.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 3 of them syntheses that pooled it.
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Who cites it
42 citing papers in PubMed, 3 syntheses or guidelines pooled it, 85 citations in OpenAlex.
- Anorectal manometry to diagnose dyssynergic defecation: Systematic review and meta-analysis of diagnostic test accuracy.Neurogastroenterology and motility · 2021Pooled it
- Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review.United European gastroenterology journal · 2020Pooled it
- The international anorectal physiology working group (IAPWG) recommendations: Standardized testing protocol and the London classification for disorders of anorectal function.Neurogastroenterology and motility · 2020Guideline
- Functional and Anatomical Significance of Patulous Anus.Digestive diseases and sciences · 2026Article
- Thickening of the internal anal sphincter: correlation with external rectal intussusception and associated features at MR proctography and anal manometry.Abdominal radiology (New York) · 2026Article
- Diagnostic-Therapeutic Care Pathway in Chronic Constipation: AIGO (Italian Association of Gastroenterologists and Gastrointestinal Endoscopists) Position Paper.Journal of clinical medicine · 2026Review
- Improved Outcomes with Nerve-Sparing Technique: A Retrospective Comparison of Colorectal Surgeries for Bowel Endometriosis.International journal of women's health · 2026Article
- Age-stratified diagnostic value of high-resolution anorectal manometry in women with severe rectocele: interactions between anal relaxation rate and maximum anal resting pressure.International journal of colorectal disease · 2025Article
- Clinical relevance of transperineal ultrasound compared with anorectal manometry for the evaluation of female patients with obstructive defecation syndrome.BMC gastroenterology · 2025Article
- Quantitative proteomics analysis reveals the pathogenesis of obstructed defecation syndrome caused by abnormal expression of dystrophin.World journal of gastroenterology · 2024Article
- High-Resolution Anorectal Manometry and Balloon Expulsion Test Outcomes in Functional Constipation: A Comparative Study.Medical science monitor : international medical journal of experimental and clinical research · 2024Article
- High-resolution anorectal manometry for diagnosing obstructed defecation syndrome associated with moderate rectocele compared to healthy individuals.BMC gastroenterology · 2024Article
- Are There Sex Differences in Defecation Patterns in Patients with Defecation Disorders? - A Single-center Observational Study.Journal of the anus, rectum and colon · 2023Article
- Comparison of Anorectal Manometry, Rectal Balloon Expulsion Test, and Defecography for Diagnosing Defecatory Disorders.Gastroenterology · 2022Article
- Rectocele: Incidental or important? Observe or operate? Contemporary diagnosis and management in the multidisciplinary era.Neurogastroenterology and motility · 2022Review
- Optimizing techniques for measuring anal resting and squeeze pressures with high-resolution manometry.Neurogastroenterology and motility · 2022Article
- Abdomino-anal Dyscoordination in Defecatory Disorders.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2022Article
- Review of the indications, methods, and clinical utility of anorectal manometry and the rectal balloon expulsion test.Neurogastroenterology and motility · 2022Review
- Inadequate Rectal Pressure and Insufficient Relaxation and Abdominopelvic Coordination in Defecatory Disorders.Gastroenterology · 2022Article
- Diagnostic Strategy and Tools for Identifying Defecatory Disorders.Gastroenterology clinics of North America · 2022Review
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsContrary to conventional wisdom, the rectoanal gradient during evacuation is negative in many healthy people, undermining the utility of anorectal high-resolution manometry (HRM) for diagnosing defecatory disorders. We aimed to compare HRM and magnetic resonance imaging (MRI) for assessing rectal evacuation and structural abnormalities.
methodsWe performed a retrospective analysis of 118 patients (all female; 51 with constipation, 48 with fecal incontinence, and 19 with rectal prolapse; age, 53 ± 1 years) assessed by HRM, the rectal balloon expulsion test (BET), and MRI at Mayo Clinic, Rochester, Minnesota, from February 2011 through March 2013. Thirty healthy asymptomatic women (age, 37 ± 2 years) served as controls. We used principal components analysis of HRM variables to identify rectoanal pressure patterns associated with rectal prolapse and phenotypes of patients with prolapse.
resultsCompared with patients with normal findings from the rectal BET, patients with an abnormal BET had lower median rectal pressure (36 vs 22 mm Hg, P = .002), a more negative median rectoanal gradient (-6 vs -29 mm Hg, P = .006) during evacuation, and a lower proportion of evacuation on the basis of MRI analysis (median of 40% vs 80%, P < .0001). A score derived from rectal pressure and anorectal descent during evacuation and a patulous anal canal was associated (P = .005) with large rectoceles (3 cm or larger). A principal component (PC) logistic model discriminated between patients with and without prolapse with 96% accuracy. Among patients with prolapse, there were 2 phenotypes, which were characterized by high (PC1) or low (PC2) anal pressures at rest and squeeze along with higher rectal and anal pressures (PC1) or a higher rectoanal gradient during evacuation (PC2).
conclusionsIn a retrospective analysis of patients assessed by HRM, measurements of rectal evacuation by anorectal HRM, BET, and MRI were correlated. HRM alone and together with anorectal descent during evacuation may identify rectal prolapse and large rectoceles, respectively, and also identify unique phenotypes of rectal prolapse.
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