The use of colonic and anorectal high‐resolution manometry and its place in clinical work and in research

Abstract

This review assesses all of the HRM studies published to date from both the colon and anorectum, explores the catheter types used, and attempts to determine the worth of HRM over traditional 'low-resolution' recordings from the same regions. Ultimately, this review addresses whether HRM currently provides information that will benefit patient diagnosis and treatment.

3D High‐definition anorectal manometry: Values obtained in asymptomatic volunteers, fecal incontinence and chronic constipation. Results of a prospective multicenter study (NOMAD)

“…Similarly, we had to limit comparisons between symptomatic and asymptomatic groups to women, because of the very limited number of males included in the FI and CC groups. In the setting of this multicenter study, investigators agreed to perform 3DARM according to a standardized protocol, but we must recognize the lack of agreement in the literature on how the different procedures should be performed, and their exact place in the clinical work‐up of FI, CC and dyschesia . The 3DARM push maneuver results were not compared to other tests such as balloon expulsion test or dynamic pelvic floor imaging techniques such as defecography or dynamic pelvic MRI.…”

Anorectal manometry in children with defecation disorders BSPGHAN Motility Working Group consensus statement

“…Anorectal manometry is considered the gold standard tool for the assessment of anorectal function in adults for over a century, with high‐resolution ARM (HRAM) slowly gaining momentum . In adult practice, ARM/HRAM is used to guide management bowel symptoms such as CC, defecation disorders, and FI . However, in pediatrics, rectal manometry has yet to be fully implemented as part of routine investigations of children presenting with similar symptoms.…”

Methods of anorectal manometry vary widely in clinical practice: Results from an international survey

“…The advent of high‐resolution ARM (HR‐ARM) has brought with it a new dimension of data capture and visualization (color‐contour topographical plots), and has the potential to revolutionize appreciation of anorectal function . Unfortunately, this advancement has added a further element of variability in practice; unless efforts are made early to reach consensus on test performance, this technique may fall victim to the same pitfalls that have bedeviled other investigations in the field.…”