ArticleNeurogastroenterology and motility2019
Audit of the diagnosis of rectal evacuation disorders in chronic constipation.
Article in Neurogastroenterology and motility, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis 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
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Pretest and Post-test Probabilities of Diagnoses of Rectal Evacuation Disorders Based on Symptoms, Rectal Exam, and Basic Tests: a Systematic Review.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2020Pooled it
- Sigmoid volvulus, acute colonic pseudo-obstruction, and chronic megacolon in Parkinson disease.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026Article
- Enhancing clinical practice: The role of digital rectal examination in diagnosing functional defecation disorders.World journal of gastrointestinal surgery · 2025Review
- Overall and Regional Colonic Transit Abnormalities in Elderly Patients with Constipation.Digestive diseases and sciences · 2025Article
- Diagnosing Dyssynergic Defecation with the Digital Rectal Exam: The New Digital Revolution?Digestive diseases and sciences · 2024Article
- Review
- Irritable bowel syndrome and mental health comorbidity - approach to multidisciplinary management.Nature reviews. Gastroenterology & hepatology · 2023Review
- Potential Value of Biomarker-Based Approaches for Evaluation and Management of Costly Functional Gastrointestinal Diseases.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2023Review
- Review
- Review of the indications, methods, and clinical utility of anorectal manometry and the rectal balloon expulsion test.Neurogastroenterology and motility · 2022Review
- Rectal Evacuation Disorders in Patients Presenting With Chronic Functional Diarrhea.Gastro hep advances · 2022Review
- Does sequential balloon expulsion test improve the screening of defecation disorders?BMC gastroenterology · 2020Article
- Sex as a biological variable in irritable bowel syndrome.Neurogastroenterology and motility · 2020Review
- Review
- Management of functional constipation in children and adults.Nature reviews. Gastroenterology & hepatology · 2020Review
- What's in the pipeline for lower functional gastrointestinal disorders in the next 5 years?American journal of physiology. Gastrointestinal and liver physiology · 2019Review
- Personalized medicine in functional gastrointestinal disorders: Understanding pathogenesis to increase diagnostic and treatment efficacy.World journal of gastroenterology · 2019Review
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundBalloon expulsion test (BET) and high-resolution anorectal manometry (HRM) are used in diagnosis of rectal evacuation disorders (REDs); their performance characteristics are suboptimal.
methodsWe audited records of 449 consecutive patients with chronic constipation (CC). We documented anal sphincter tone and contraction, puborectalis tenderness, and perineal descent on digital rectal exam (DRE); maximum resting and squeeze pressures, and rectoanal pressure gradient on HRM; weight or time to balloon expulsion; colonic transit, and area of rectal area on radiograph (RASF). We based the diagnosis of RED on ≥2 abnormalities on both DRE and HRM, excluding results of BET, as the performance of BET is being investigated. Results of RED vs non-RED and results obtained using tbBET vs wbBET groups were compared. We used multivariate logistic regressions to identify predictors of RED using different diagnostic modalities. KEY
resultsAmong 449 individuals, 276 were included (74 RED and 202 non-RED). Predominant exclusions were for no HRM (n = 79) or use of low resolution anorectal manometry (n = 77). Logistic regression models for abnormal tbBET showed time >60 seconds, RASF and age-predicted RED. For tbBET, the current cutoff of 60 seconds had sensitivity of 39.0% and specificity 93.0% to diagnose RED; on the other hand, applying the cutoff at 22 seconds, the sensitivity was 77.8% and specificity 69.8%. CONCLUSIONS & INFERENCES: The clinical diagnosis of RED in patients with CC is achieved with combination of DRE, HRM and an optimized, time-based BET. Prospective studies are necessary to confirm the proposed 22 second cutoff for tbBET.
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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.