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.
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 -
