Evidence map›Paper›PMID 32815246›Full record

ArticleNeurogastroenterology and motility2021

A new method for assessing anal distensibility with a barostat and magnetic resonance imaging in healthy and constipated women.

Mayank Sharma, Kelly Feuerhak, Stephen M Corner, Armando Manduca, Adil E Bharucha

Open access · bronzeAbstract read
In one paragraph

Article in Neurogastroenterology and motility, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.5field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Mayank SharmaDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Kelly FeuerhakDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Stephen M CornerDivision of Engineering, Mayo Clinic, Rochester, MN, USA.
Armando ManducaDepartment of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA.
Adil E BharuchaDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.ORCID 0000-0002-7644-0390
Mayo Clinic in Arizona · USMayo Clinic · USMayo Clinic in Florida · US

Funding

Pathophysiology of Anorectal DisordersR01DK078924 · NIDDK · MAYO CLINIC ROCHESTER · PI BHARUCHA, ADIL E. · 2008 to 2023
$5.0M
NIDDK NIH HHS R01 DK078924
6 · The paper itself

Abstract

objectivesDefecation requires relaxation of the internal and external anal sphincters. High anal resting pressure is associated with painful constipation, defecatory disorders, and increased healthcare utilization in constipated patients; the mechanisms are unclear. Perhaps patients with a high anal resting pressure have a less distensible canal, which impedes defecation.

methodsIn 50 of 64 participants (33 healthy and 17 constipated women), anal pressures and distensibility were measured, respectively, with manometry and balloon distention combined with magnetic resonance imaging; rectal balloon expulsion time (BET) was also studied.

resultsThe BET (P = .006) was longer, and the mean (SD) rectoanal pressure gradient (-58[40] vs -34[26] mm Hg, P = .03) was more negative in constipated than healthy women; anal resting pressure was not different. During anal distention, the balloon expanded rapidly at an opening pressure of 49 (18) mm Hg, which was lower (P < .0001) than resting pressure (90 [25] mm Hg). The resting pressure was correlated with the opening pressure (r = 0.57, P < .0001) and inversely (r = -0.38, P = .007) with maximum volume but not with anal distensibility (volume-pressure slope). In healthy women, the difference (opening-resting pressure) was correlated with anal relaxation during evacuation (r = 0.35, P = .04). Anal distensibility and sensory thresholds were not different between constipated and healthy women.

conclusionsAmong healthy and constipated women, a greater anal resting pressure is correlated with greater opening pressure and lower maximum volume during distention, and, hence, provides a surrogate marker of anal distensibility. The difference (opening-resting pressure), which reflects anal relaxation during distention, is correlated with anal relaxation during evacuation. Anal resting pressure and distensibility were comparable in healthy and constipated women.

Indexed as

AdultAnal CanalConstipationFemaleHumansMagnetic Resonance ImagingManometryMiddle AgedcomplianceconstipationEndoFlippelvic floor dysfunction

Identifiers

PMID32815246
PMCPMC7864861
OpenAlexW3081067615

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Registered trials

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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.