Sa1347 Identification of Overlapping Dyssynergic Defecation in Women With Fecal Incontinence Undergoing Anorectal Manometry and Balloon Expulsion Test

2015 ◽  
Vol 148 (4) ◽  
pp. S-298
Author(s):  
Toyia N. James-Stevenson ◽  
Andrea Shin ◽  
Basile Njei ◽  
Thomas F. Imperiale
Keyword(s):  
Fecal Incontinence ◽  
Anorectal Manometry ◽  
Dyssynergic Defecation ◽  
Balloon Expulsion ◽  
Balloon Expulsion Test

scholarly journals Abnormal Balloon Expulsion Test in Patients with Fecal Incontinence

2020 ◽  
Author(s):  
Leila Neshatian ◽  
Chimi Fosso ◽  
Eamonn Quigley
Keyword(s):  
Fecal Incontinence ◽  
Clinical Symptoms ◽  
Pressure Profile ◽  
Sensory Threshold ◽  
Factors Associated ◽  
Wilcoxon Rank Sum Test ◽  
Balloon Expulsion ◽  
Surgical History ◽  
Balloon Expulsion Test ◽  
Anorectal Pressure

Background and Aims: Functional defecatory dysfunction is attributed to the pathophysiology of fecal incontinence (FI) in some patients. We hypothesized that patients with FI and abnormal balloon expulsion test (BET) have distinct manometric characteristics as compared to the patients with FI and normal BET. We aimed to compare the anorectal pressure profile in patients with FI, with or without abnormal BET and to identify risk factors associated with abnormal BET in FI. Methods: We performed a retrospective review of 77 consecutive patients with ROME IV FI. Wilcoxon rank sum test, t-test, and Fisher exact tests were performed for comparison. Multivariable logistic regression was performed to identify factors associated with abnormal BET. Results: Thirty-two percent of patients had abnormal BET. Demographics and surgical history and clinical symptoms, except for sensation of incomplete evacuation (p=0.02) and abdominal pain (p=0.03), were comparable in both groups. Anorectal pressure profile except for the median rectal propulsive pressures were similar between groups. Rectal propulsive pressures at simulated defecation were significantly lower in patients with abnormal BET (p=0.02). Mean sensory threshold for first sensation was also significantly higher in patients who had abnormal BET (p=0.03). Rectal propulsive pressures (OR: 1.03, 95% CI: 1.00-1.06, p=0.032) and rectal sensory threshold for first sensation (OR:0.94, 95% CI: 0.90-0.99, p=0.02) were able to predict abnormal BET independently. Conclusions: In patients with FI and similar clinical and anal pressure profile, rectal sensory threshold and rectal propulsive pressures at simulated defecation can determine normal BET.

scholarly journals The London Classification: Improving Characterization and Classification of Anorectal Function with Anorectal Manometry

2020 ◽  
Vol 22 (11) ◽  
Author(s):  
S. Mark Scott ◽  
Emma V. Carrington
Keyword(s):  
Clinical Practice ◽  
Anorectal Manometry ◽  
Working Group ◽  
Anorectal Function ◽  
Sensory Function ◽  
Sensorimotor Function ◽  
Sensory Testing ◽  
Balloon Expulsion ◽  
Balloon Expulsion Test

Abstract Purpose of Review Objective measurement of anorectal sensorimotor function is a requisite component in the clinical evaluation of patients with intractable symptoms of anorectal dysfunction. Regrettably, the utility of the most established and widely employed investigations for such measurement (anorectal manometry (ARM), rectal sensory testing and the balloon expulsion test) has been limited by wide variations in clinical practice. Recent Findings This article summarizes the recently published International Anorectal Physiology Working Group (IAPWG) consensus and London Classification of anorectal disorders, together with relevant allied literature, to provide guidance on the indications for, equipment, protocol, measurement definitions and results interpretation for ARM, rectal sensory testing and the balloon expulsion test. Summary The London Classification is a standardized method and nomenclature for description of alterations in anorectal motor and sensory function using office-based investigations, adoption of which should bring much needed harmonization of practice.

scholarly journals Prevalence and Clinical Characteristics of Dyssynergic Defecation and Slow Transit Constipation in Patients with Chronic Constipation

2021 ◽  
Vol 10 (9) ◽  
pp. 2027
Author(s):  
Samuel Tanner ◽  
Ahson Chaudhry ◽  
Navneet Goraya ◽  
Rohan Badlani ◽  
Asad Jehangir ◽  
...  
Keyword(s):  
Medical History ◽  
Chronic Constipation ◽  
Clinical Characteristics ◽  
Anorectal Function ◽  
Slow Transit Constipation ◽  
Dyssynergic Defecation ◽  
Patient Demographics ◽  
Balloon Expulsion ◽  
Slow Transit ◽  
Transit Constipation

Patients with chronic constipation who do not respond to initial treatments often need further evaluation for dyssynergic defecation (DD) and slow transit constipation (STC). The aims of this study are to characterize the prevalence of DD and STC in patients referred to a motility center with chronic constipation and correlate diagnoses of DD and STC to patient demographics, medical history, and symptoms. High-resolution ARM (HR-ARM), balloon expulsion testing (BET) and whole gut transit scintigraphy (WGTS) of consecutive patients with chronic constipation were reviewed. Patients completed questionnaires describing their medical history and symptoms at the time of testing. A total of 230 patients completed HR-ARM, BET, and WGTS. Fifty (22%) patients had DD, and 127 (55%) patients had STC. Thirty patients (13%) had both DD and STC. There were no symptoms that were suggestive of STC vs. DD; however, patients with STC and DD reported more severe constipation than patients with normal transit and anorectal function. Patients with chronic constipation often need evaluation for both DD and STC to better understand their pathophysiology of symptoms and help direct treatment.

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