Do endoflip assessments of anal sphincter distensibility provide more information on patients with fecal incontinence than high‐resolution anal manometry?

Abstract

The present study confirmed that FI is associated with an abnormally high distensibility index at rest and during voluntary contraction. The ability of the distensibility index to discriminate between FI patients and healthy subjects was significantly better than anal pressure.

Emerging Roles of the Endolumenal Functional Lumen Imaging Probe in Gastrointestinal Motility Disorders

“…14 Similar results were reported by Alqudah et al 37 In a study by Gourcerol et al 38 comparing the use of EndoFLIP and 3-dimensional high-resolution manometry, it was found that anal distensibility index was higher at rest and during voluntary contraction in fecal incontinence than in healthy subjects, and that the discrimination was better using the distensibility index as compared with the anal pressure. EndoFLIP may be used intra-operatively to assess the anal sphincter geometry and tightness during repair or augmentation.…”

Anatomy and mechanical properties of the anal sphincter muscles in healthy senior volunteers

“…Moreover, this study employed a new approach for the quantification of voluntary muscle properties from FLIP measurements during contraction maneuvers. In the past, different measures have been used to quantify muscle fitness, such as the area of the combined diameter‐time change, the distensibility index (cross‐sectional area versus pressure), and wall tension . However, these measures do not simultaneously take into account both the amount of orifice closing and the force required for achieving this level of closing.…”

“…However, no standardized protocols exist for assessing and analyzing FLIP measurements, and FLIP does not provide any anatomical information. Consequently, previous studies reported involuntary and voluntary AC properties only at selected positions and without direct reference to patients’ actual anatomy . This absence of anatomical information hinders understanding the contribution of the different muscles to continence.…”

“…The voluntary properties reflect the ability of the continence organ to squeeze, that is, the capacity of the muscles to close the AC and to locally reduce the diameter of the FLIP balloon at a given volume. Initial studies revealed differences in involuntary and voluntary mechanical properties of the continence organ between FI patients and the healthy population …”

Functional lumen imaging probe in gastrointestinal motility diseases

“…Compared with healthy controls, DI of the anal sphincter was found to be higher during voluntary contraction and at rest in patients with FI. Moreover, the evaluation was more practical with DI by FLIP than using the anal pressure by HRAM . The diagnostic value of FLIP in measuring the anal DI was further confirmed by a recent study of 33 patients with FI .…”