ArticleJournal of neurogastroenterology and motility2017
Balloon Expulsion Test Does Not Seem to Be Useful for Screening or Exclusion of Dyssynergic Defecation as a Single Test.
Article in Journal of neurogastroenterology and motility, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- [Seoul Consensus on Clinical Practice Guidelines for Functional Constipation].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2025Guideline
- Anorectal manometry to diagnose dyssynergic defecation: Systematic review and meta-analysis of diagnostic test accuracy.Neurogastroenterology and motility · 2021Pooled it
- Diagnostic Value of the Anal Endoluminal Functional Luminal Imaging Probe for the Diagnosis of Anismus: An Exploratory Study.Neurogastroenterology and motility · 2026Article
- Management of constipation: A narrative review of evolving strategies and methodological challenges.World journal of methodology · 2026Review
- Urinary Dysfunction Is Common in Patients with Fecal Urgency and May Relate to Altered Rectal Biomechanics.Digestive diseases and sciences · 2025Article
- 2022 Seoul Consensus on Clinical Practice Guidelines for Functional Constipation.Journal of neurogastroenterology and motility · 2023Review
- Review of the indications, methods, and clinical utility of anorectal manometry and the rectal balloon expulsion test.Neurogastroenterology and motility · 2022Review
- Rectal Distension Increased the Rectoanal Gradient in Patients with Normal Rectal Sensory Function.Digestive diseases and sciences · 2021Article
- Audit of the diagnosis of rectal evacuation disorders in chronic constipation.Neurogastroenterology and motility · 2019Article
- Expert consensus document: Advances in the evaluation of anorectal function.Nature reviews. Gastroenterology & hepatology · 2018Review
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
aimsBalloon expulsion test (BET) is regarded as a screening tool of dyssynergic defecation (DD). However, some patients with normal BET results may be treated effectively by biofeedback training. This study aims to validate BET as a single screening test.
methodsTwo hundred and thirty-two patients who were diagnosed with functional constipation or irritable bowel syndrome with constipation who underwent anorectal manometry (ARM) and BET at Seoul National University Hospital were enrolled. We evaluated the validity of BET based on ARM and electromyography (EMG) during biofeedback training.
resultsIf BET ≤ 1 minute was defined as normal, sensitivity and negative predictive value (NPV) of BET in predicting paradoxical contraction based on ARM findings were 71.4% and 13.9%. If BET ≤ 3 minutes was defined as normal, sensitivity and NPV were 35.2% and 6.6%. Specificity and positive predictive value (PPV) of BET ≤ 3 minutes criteria were 84.8% and 93.3%. Same analysis was conducted in 107 patients who underwent EMG during biofeedback training. With 1-minute criteria, sensitivity and NPV of BET were 70.3% and 14.3%. With 3 minutes criteria, sensitivity and NPV of BET was 38.6% and 8.8%. Specificity and positive predictive values were both 100.0%.
conclusionsBased on either ARM or EMG during biofeedback training, sensitivity was at most 71.4% and NPV was less than 15.0% irrespective of whether BET was within 1minute or within 3 minutes. BET seems to have a limitation as both a screening test for dyssynergic defecation and a simple assessment to rule out the necessity of biofeedback training.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.