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How useful are manometric tests of anorectal function in the management of defecation disorders?
Am J Gastroenterol 1997; 92(3):469-75AJ

Abstract

OBJECTIVES

The clinical usefulness of assessing anorectal physiology has not been systematically examined. Our aims were to evaluate whether manometric tests of anorectal function influence the management and outcome of patients with defecation disorders, and to identify the patients who may most benefit from this assessment.

METHODS

Using a standard protocol of anorectal manometry rectal sensation, saline continence, simulated defecation, and pudendal nerve terminal latency tests, we studied 143 consecutive patients (m/f = 27/116) and followed their progress over 18 months.

RESULTS

Tests of anorectal function in 126 (88%) patients revealed new information that led to a change in the management of 108 (76%) patients. Among 69 patients referred with constipation, 33 (48%) had obstructive defecation, and 40 (58%) had impaired rectal sensation; 30 (43%) improved after biofeedback therapy. Among 56 patients referred with fecal incontinence, 55 (98%) had manometric abnormalities: 30 (53%) had a low squeeze sphincter pressure, 20 (36%) had impaired rectal sensation, and 28 (50%) had pudendal neuropathy. Thiry-four (60%) patients were referred for biofeedback therapy and 11 (20%) for surgery. Of these 15 completed biofeedback therapy with improvement, and six had successful surgery. Seven of 10 (70%) patients referred for preoperative evaluation had abnormalities that contraindicated surgery.

CONCLUSIONS

Manometric tests of anorectal function provide not only an objective diagnosis but, also, a better understanding of the underlying pathophysiology. In addition, it provides new information that could influence the management and outcome of patients with disorders of defecation.

Authors+Show Affiliations

Division of Gastroenterology, University of Iowa, College of Medicine, Iowa City, USA.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9068472

Citation

Rao, S S., and R S. Patel. "How Useful Are Manometric Tests of Anorectal Function in the Management of Defecation Disorders?" The American Journal of Gastroenterology, vol. 92, no. 3, 1997, pp. 469-75.
Rao SS, Patel RS. How useful are manometric tests of anorectal function in the management of defecation disorders? Am J Gastroenterol. 1997;92(3):469-75.
Rao, S. S., & Patel, R. S. (1997). How useful are manometric tests of anorectal function in the management of defecation disorders? The American Journal of Gastroenterology, 92(3), pp. 469-75.
Rao SS, Patel RS. How Useful Are Manometric Tests of Anorectal Function in the Management of Defecation Disorders. Am J Gastroenterol. 1997;92(3):469-75. PubMed PMID: 9068472.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - How useful are manometric tests of anorectal function in the management of defecation disorders? AU - Rao,S S, AU - Patel,R S, PY - 1997/3/1/pubmed PY - 1997/3/1/medline PY - 1997/3/1/entrez SP - 469 EP - 75 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 92 IS - 3 N2 - OBJECTIVES: The clinical usefulness of assessing anorectal physiology has not been systematically examined. Our aims were to evaluate whether manometric tests of anorectal function influence the management and outcome of patients with defecation disorders, and to identify the patients who may most benefit from this assessment. METHODS: Using a standard protocol of anorectal manometry rectal sensation, saline continence, simulated defecation, and pudendal nerve terminal latency tests, we studied 143 consecutive patients (m/f = 27/116) and followed their progress over 18 months. RESULTS: Tests of anorectal function in 126 (88%) patients revealed new information that led to a change in the management of 108 (76%) patients. Among 69 patients referred with constipation, 33 (48%) had obstructive defecation, and 40 (58%) had impaired rectal sensation; 30 (43%) improved after biofeedback therapy. Among 56 patients referred with fecal incontinence, 55 (98%) had manometric abnormalities: 30 (53%) had a low squeeze sphincter pressure, 20 (36%) had impaired rectal sensation, and 28 (50%) had pudendal neuropathy. Thiry-four (60%) patients were referred for biofeedback therapy and 11 (20%) for surgery. Of these 15 completed biofeedback therapy with improvement, and six had successful surgery. Seven of 10 (70%) patients referred for preoperative evaluation had abnormalities that contraindicated surgery. CONCLUSIONS: Manometric tests of anorectal function provide not only an objective diagnosis but, also, a better understanding of the underlying pathophysiology. In addition, it provides new information that could influence the management and outcome of patients with disorders of defecation. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/9068472/How_useful_are_manometric_tests_of_anorectal_function_in_the_management_of_defecation_disorders L2 - https://medlineplus.gov/constipation.html DB - PRIME DP - Unbound Medicine ER -