External Anal Sphincter Fatigability: An Electromyographic and Manometric Study in Patients With Anorectal Disorders

Grasland, Matthieu; Turmel, Nicolas; Pouyau, Camille; Leroux, Camille; Charlanes, A.; Chesnel, C.; Breton, F. Le; Sheikh-Ismael, Samer; Amarenco, G.; Hentzen, Claire

doi:10.5056/jnm20024

Cited by 3 publications

(2 citation statements)

References 30 publications

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“…Although there are few studies performed regarding the FRI, a recent study included the FR and the FRI as manometric parameters in the evaluation of the fatigability of the EAS in adults with anorectal disorders (25) . This is a preliminary study that aims to assess the feasibility of the fatigue rate and the FRI in the assessment of the voluntary contraction of children who underwent an anorectal manometry and were followed at our center.…”

Section: Discussionmentioning

confidence: 99%

The Fatigue Rate Index Is Higher in Children With Functional Constipation and Retentive Fecal Incontinence

Paganotti

Miasato

Morais

et al. 2022

Arq. Gastroenterol.

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Background: The Fatigue Rate Index (FRI) is a parameter in anorectal manometry (ARM) to assess sustained voluntary contraction, considering the squeeze pressure and fatigability of the external anal sphincter. It is used in adults to detect fecal incontinence even in patients who present normal squeeze pressures. The FRI in adult patients with functional constipation is similar to controls. Objective: The aim of this study was to evaluate the feasibility and values of FRI in children in relation to the values previously established in adults and comparing children with functional constipation and retentive fecal incontinence to children without retentive fecal incontinence. Methods: This retrospective study evaluated 105 ARM performed from Jan 2014 to Apr 2015. 42 patients were selected (were able to perform a voluntary contraction and had no co-morbidities other than functional constipation). 14 (33.3%) of those collaborated in sustaining contraction for 40 seconds (s), allowing the evaluation of the FRI. Patients with retentive fecal incontinence secondary to functional constipation (n=7, aged 6 to 13 years, six boys) were our interest group. Patients with functional constipation without fecal incontinence (n=7, aged 6 to 13 years, four boys) were considered a reference group. The ARM were performed with a radial eight-channel perfusion catheter (DynamedTM, São Paulo, Brazil) and the FRI was calculated (Proctomaster 6.4) in the first 20 s and overall 40 s of sustained voluntary contraction. Results: 14 of the selected 42 collaborated in sustaining contraction for 40 s, allowing the evaluation of the FRI. In the first 20 s of contraction, the fecal incontinence group showed a significantly higher mean FRI (2.48±1.39 min) compared to the reference group (1.13±0.72 min, P=0.042), which was not observed in the 40 s interval due to less uniform contraction. The anal resting pressure was higher in the fecal incontinence group (76.83 mmHg) than in the reference group (54.13 mmHg), but the statistical study did not reach significance (P=0.051). Conclusion: The FRI is feasible in children. The mean FRI obtained in this study is lower than the reported in constipated adults. The mean FRI among children with functional constipation and retentive fecal incontinence is higher than among constipated children without retentive fecal incontinence.

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Section: Discussionmentioning

confidence: 99%

The Fatigue Rate Index Is Higher in Children With Functional Constipation and Retentive Fecal Incontinence

Paganotti

Miasato

Morais

et al. 2022

Arq. Gastroenterol.

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“…Squeeze maneuvers that are more frequent and/or against a resistive load are more likely to evoke sphincter fatigue. Further studies are necessary 44,45 …”

Section: Methodsmentioning

confidence: 99%

Review of the indications, methods, and clinical utility of anorectal manometry and the rectal balloon expulsion test

Bharucha

Basilisco

Malcolm

et al. 2022

Neurogastroenterology Motil

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Anorectal manometry (ARM) is a sophisticated technique that quantifies several aspects of the complex and multifactorial mechanisms that regulate defecation and continence. 1 ARM records contractility and tone of the internal (IAS) and external anal sphincters (EAS); rectal sensitivity and compliance; the reflex relaxation of the IAS in response to rectal distension; the reflex contraction of the EAS in response to cough or Valsalva maneuver; and the dynamic changes of rectal and anal pressures during simulated evacuation. The technological advances of ARM and other techniques that assess colonic and anorectal functions (e.g., high-resolution colonic manometry and magnetic resonance imaging [MRI] proctography) have enhanced our understanding of the physiology of defecation and continence and related disorders. Anorectal manometry and the rectal balloon expulsion test are recommended initial tests for diagnosing DD in patients who have

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Anorectal manometry — How to perform and interpret manometry

Gala,

Johnston,

Solanki

et al. 2024

Continence

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External Anal Sphincter Fatigability: An Electromyographic and Manometric Study in Patients With Anorectal Disorders

Cited by 3 publications

References 30 publications

The Fatigue Rate Index Is Higher in Children With Functional Constipation and Retentive Fecal Incontinence

The Fatigue Rate Index Is Higher in Children With Functional Constipation and Retentive Fecal Incontinence

Review of the indications, methods, and clinical utility of anorectal manometry and the rectal balloon expulsion test

Anorectal manometry — How to perform and interpret manometry

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