Three-dimensional high-resolution anorectal manometry in functional anorectal disorders: results from a large observational cohort study

Andrianjafy, Charlotte; Luciano, Laure; Bazin, Camille; Baumstarck, Karine; Bouvier, Michel; Vitton, Véronique

doi:10.1007/s00384-019-03235-z

Cited by 9 publications

(8 citation statements)

References 43 publications

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“…Besides, the quantitative parameters of pressure changes in the rectum and anus during attempted defecation, such as anal relaxation rate, MDI and RAG, are useful to diagnose FDD 11 and MDI serves as a simple and useful quantitative measure of rectoanal coordination during defecation 34 . According to our ndings, FDD patients with positive BET and PFD mainly had problems with impaired anal sphincter relaxation and paradoxical anal sphincter contraction, which may be associated with abnormal external anal sphincter (EAS) and/or puborectalis muscle contraction 35 .…”

Section: Discussionmentioning

confidence: 87%

Clinical Value of Positive BET and Pelvic Floor Dyssynergia in Chinese Patients with Functional Defecation Disorder

Jiang¹,

Wang²,

Tang³

et al. 2021

Preprint

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Background Functional defecation disorder (FDD) is a common subtype of functional constipation (FC). Balloon expulsion test (BET) and high resolution anorectal manometry (HR-ARM) are significant tools but their results are not always consistent. Aims To investigate the characteristics of patients with positive BET and pelvic floor dyssynergia (PFD) and explore the value of both positive results in FDD diagnosis. Methods We retrospectively diagnose FC subtypes and enrolled FDD patients based on Rome-IV criteria. They underwent HR-ARM, BET and CTT tests. Then they were classified to 2 groups and further stratified by FDD subtypes. Validated questionnaires were applied to investigate patients’ constipation, anxiety/depression and quality of life. Results 335 FDD patients were finally enrolled. They were classified into 2 groups according to whether BET and PFD were both positive (consistent or not). 84.48% showed consistent results. These patients had significantly higher anal residual pressure, lower anal relaxation rate, MDI and a more negative RAPG (Ps < 0.05). The specific distribution of FDD phenotypes in two groups showed significant difference (P = 0.021). Males suffered a more negative RAPG (P < 0.001) and age was correlated with anal relaxation rate (P < 0.001). 177 individuals among them were investigated with validated questionnaires. Scores for Defecation Symptoms, Physical Discomfort and GAD-7 score were significantly high in Consistent Group (Ps < 0.05). GAD-7 score was associated with Defecation Symptoms (P < 0.001) while anal residual pressure, GAD-7 and Defecation Symptoms score were linked to Physical Discomfort (Ps < 0.05). The diagnostic specificity and PPV for FDD rose significantly with positive BET and PFD. Conclusion FDD patients with positive BET and PFD suffer severe defecation symptoms, anxiety and impaired QOL. Positive BET and PFD could be an ideal tool for screening FDD.

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Section: Discussionmentioning

confidence: 87%

Clinical Value of Positive BET and Pelvic Floor Dyssynergia in Chinese Patients with Functional Defecation Disorder

Jiang¹,

Wang²,

Tang³

et al. 2021

Preprint

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“…42,60,72, 84,85,93,109,115,118,140,161–163,171,172,181,184,186,187,230–232,238, 240,256,260,308,314,320,329,342,344,355 In 13 studies (4.2%) 53, 58,65,108,111,142,143,145,159,316,337,343,351 non-validated questionnaires were used. Anal manometry was used in 126 studies (41.2%) 50,53,55,57,61,65,72,73,77,78,80,82,83, 85,86,91,92,95,96,…”

Section: Resultsmentioning

confidence: 99%

“…After careful evaluation of full‐text papers 27 studies were excluded: 15 studies 23–37 did not evaluate FI assessment, six manuscripts 38–43 were just protocols, five were paediatric studies, 44–48 and one trial 49 had an inappropriate study design. Finally, 328 studies were included in our review: 306 studies…”

Section: Resultsmentioning

confidence: 99%

“…FI was assessed using specific questionnaires in all studies, except for four trials 168 , 213 , 274 , 280 . Twenty‐nine different questionnaires were applied: the most widely adopted were the Wexner score (187 studies), 50 , 52 , 54 , 55 , 59 , 61 , 63 , 66 , 69–71 , 73–83 , 86–92 , 97–99 , 101 , 103–107 , 110 , 114 , 116 , 117 , 120–123 , 126–128 , 130 , 131 , 133 , 135–139 , 141 , 144 , 146–156 , 160 , 164–167 , 169 , 170 , 174 , 177–179 , 182 , 194–203 , 205–208 , 210–212 , 214 , 215 ,…”

Section: Resultsmentioning

confidence: 99%

“…In 13 studies (4.2%) 53 , 58 , 65 , 108 , 111 , 142 , 143 , 145 , 159 , 316 , 337 , 343 , 351 non‐validated questionnaires were used. Anal manometry was used in 126 studies (41.2%) 50 , 53 , 55 , 57 , 61 , 65 , 72 , 73 , 77 , 78 , 80 , 82 , 83 , 85 , 86 , 91 , 92 , 95 , 96 , 98 , 103–107 , 109 , 111 , 115 , 122 , 123 , 125 , 127 , 134 , 141 , 142 , 146 , 151–153 , 155 , 162–165 , 167 , 168 , 170 , 174–176 , 178 , 179 , 183 , 191 , 193 , 199–201 , 204 , 206 , 213 , 217 ,…”

Section: Resultsmentioning

confidence: 99%

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Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review

et al. 2020

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Background Fecal incontinence is a disabling condition affecting up to 20% of women. Objective We investigated fecal incontinence assessment in both inflammatory bowel disease and non-inflammatory bowel disease patients to propose a diagnostic approach for inflammatory bowel disease trials. Methods We searched on Pubmed, Embase and Cochrane Library for all studies on adult inflammatory bowel disease and non-inflammatory bowel disease patients reporting data on fecal incontinence assessment from January 2009 to December 2019. Results In total, 328 studies were included; 306 studies enrolled non-inflammatory bowel disease patients and 22 studies enrolled inflammatory bowel disease patients. In non-inflammatory bowel disease trials the most used tools were the Wexner score, fecal incontinence quality of life questionnaire, Vaizey score and fecal incontinence severity index (in 187, 91, 62 and 33 studies). Anal manometry was adopted in 41.2% and endoanal ultrasonography in 34.0% of the studies. In 142 studies (46.4%) fecal incontinence evaluation was performed with a single instrument, while in 64 (20.9%) and 100 (32.7%) studies two or more instruments were used. In inflammatory bowel disease studies the Wexner score, Vaizey score and inflammatory bowel disease quality of life questionnaire were the most commonly adopted tools (in five (22.7%), five (22.7%) and four (18.2%) studies). Anal manometry and endoanal ultrasonography were performed in 45.4% and 18.2% of the studies. Conclusion Based on prior validation and experience, we propose to use the Wexner score as the first step for fecal incontinence assessment in inflammatory bowel disease trials. Anal manometry and/or endoanal ultrasonography should be taken into account in the case of positive questionnaires.

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Performing, Analyzing, and Interpreting HRAM and HDAM Recordings

Battaglia¹,

D’Alba

Brocca³

et al. 2020

High Resolution and High Definition Anorectal Manometry

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Three-dimensional high-resolution anorectal manometry in functional anorectal disorders: results from a large observational cohort study

Cited by 9 publications

References 43 publications

Clinical Value of Positive BET and Pelvic Floor Dyssynergia in Chinese Patients with Functional Defecation Disorder

Clinical Value of Positive BET and Pelvic Floor Dyssynergia in Chinese Patients with Functional Defecation Disorder

Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review

Performing, Analyzing, and Interpreting HRAM and HDAM Recordings

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