ArticleGastroenterology2022
Inadequate Rectal Pressure and Insufficient Relaxation and Abdominopelvic Coordination in Defecatory Disorders.
Article in Gastroenterology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 24 citations in OpenAlex.
- 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
- Dyssynergia phenotypes in obstructed defecation: insights from Fecobionics assessment.BMJ open gastroenterology · 2026Observational
- Symptoms of Constipation: Relationship Between Questionnaires and Diaries and Impact on Quality of Life.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2026Article
- Inadequate Propulsion and Pelvic Floor Relaxation in Dyssynergic Defecation: Insights From Synchronous Proctomanometry.Gastroenterology · 2025Article
- 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
- Botulinum toxin type A injection combined with biofeedback in the treatment of spastic pelvic floor syndrome.World journal of clinical cases · 2024Article
- Defecatory disorders are a common cause of chronic constipation in Parkinson disease.Neurogastroenterology and motility · 2024Article
- Flow simulations of rectal evacuation: towards a quantitative evaluation from video defaecography.Interface focus · 2022Article
- Reproducibility of high-resolution manometry among healthy and constipated persons.Neurogastroenterology and motility · 2022Article
- Comparison of Anorectal Manometry, Rectal Balloon Expulsion Test, and Defecography for Diagnosing Defecatory Disorders.Gastroenterology · 2022Article
- Review of the indications, methods, and clinical utility of anorectal manometry and the rectal balloon expulsion test.Neurogastroenterology and motility · 2022Review
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsDiagnostic tests for defecatory disorders (DDs) asynchronously measure anorectal pressures and evacuation and show limited agreement; thus, abdominopelvic-rectoanal coordination in normal defecation and DDs is poorly characterized. We aimed to investigate anorectal pressures, anorectal and abdominal motion, and evacuation simultaneously in healthy and constipated women.
methodsAbdominal wall and anorectal motion, anorectal pressures, and rectal evacuation were measured simultaneously with supine magnetic resonance defecography and anorectal manometry. Evacuators were defined as those who attained at least 25% rectal evacuation. Supervised (logistic regression and random forest algorithm) and unsupervised (k-means cluster) analyses identified abdominal and anorectal variables that predicted evacuation.
resultsWe evaluated 28 healthy and 26 constipated women (evacuators comprised 19 healthy participants and 8 patients). Defecation was initiated by abdominal wall expansion that was coordinated with anorectal descent, increased rectal and anal pressure, and then anal relaxation and rectal evacuation. Compared with evacuators, nonevacuators had lower anal diameters during simulated defecation, rectal pressure, anorectal junction descent, and abdominopelvic-rectoanal coordination (P < .05). Unsupervised cluster analysis identified 3 clusters that were associated with evacuator status (P < .01), that is, 10 evacuators (83%), 16 evacuators (73%), and 1 evacuator (5%) in clusters 1, 2, and 3, respectively. Each cluster had distinct characteristics (eg, maximum abdominosacral distance, rectal pressure, anorectal junction descent, anal diameter) and correlates that were more (clusters 1-2) or less (cluster 3) conducive to evacuation. Cluster 2 had 16 evacuators (73%) and intermediate characteristics (eg, lower anal resting pressure and relaxation during evacuation; P < .05).
conclusionsWomen with DDs and a modest proportion of healthy women had specific patterns of anorectal dysfunction, including inadequate rectal pressurization, anal relaxation, and abdominopelvic-rectoanal coordination. These observations may guide individualized therapy for DDs in the future.
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