scholarly journals Diagnostic value of the balloon expulsion test compared with anorectal manometry in Indian patients with dyssynergic defecation

2020 ◽  
Vol 15 (2) ◽  
pp. 151-155
Author(s):  
Mayank Jain ◽  
Saransh Singh ◽  
Rajiv Baijal
Keyword(s):  
Anorectal Manometry ◽  
Diagnostic Value ◽  
Dyssynergic Defecation ◽  
Indian Patients ◽  
Balloon Expulsion ◽  
Balloon Expulsion Test

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.

Benefit of Pelvic Floor Physical Therapy in Pediatric Patients with Dyssynergic Defecation Constipation

2019 ◽  
Vol 37 (6) ◽  
pp. 478-485 ◽  
Author(s):  
Claire Zar-Kessler ◽  
Braden Kuo ◽  
Elizabeth Cole ◽  
Anna Benedix ◽  
Jaime Belkind-Gerson
Keyword(s):  
Physical Therapy ◽  
Pelvic Floor ◽  
Chronic Constipation ◽  
Muscle Tone ◽  
Colonic Surgery ◽  
Tertiary Referral Center ◽  
Dyssynergic Defecation ◽  
Pelvic Floor Physical Therapy ◽  
Novel Treatment ◽  
Balloon Expulsion

Objectives: Chronic constipation is a common childhood problem and often caused or worsened by abnormal dynamics of defecation. The aim of this study was to assess the benefit of pelvic floor physical therapy (PFPT), a novel treatment in pediatrics for the treatment of chronic constipation with dyssynergic defecation. Methods: This was a retrospective study of 69 children seen at a pediatric neurogastroenterology program of a large tertiary referral center for chronic constipation and dyssynergic defecation, determined by anorectal manometry and balloon expulsion testing. We compared the clinical outcome of patients who underwent PFPT (n = 49) to control patients (n = 20) whom received only medical treatment (laxatives/stool softeners). Additionally, characteristics of the treatment group were analyzed in relation to therapeutic response. Results: Thirty-seven (76%) of the patients who received physical therapy had improvement in constipation symptoms, compared to 5 (25%) of the patients on conservative treatment (p < 0.01). Additionally, patients who received pelvic physical therapy had fewer hospitalizations for cleanouts (4 vs. 25%, p = 0.01) and ­colonic surgery than those that were treated with medical therapy exclusively (0 vs. 10%, p = 0.03). Among the patients who received physical therapy, those that suffered from anxiety and/or low muscle tone had a higher response rate (100%). There were no adverse effects from the intervention. Conclusion: The new field of pediatric PFPT is a safe and effective intervention for children with dyssynergic defecation causing or contributing to chronic constipation, particularly in children whose comorbidities include anxiety and low ­muscle tone.

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