Anorectal pressures measured with high‐resolution manometry in healthy people—Normal values and asymptomatic pelvic floor dysfunction. Issue 7 (8th April 2019)

• Record Type: Journal Article
• Authors: Oblizajek, Nicholas R.; Gandhi, Sangeetha; Sharma, Mayank; Chakraborty, Subhankar; Muthyala, Anjani; Prichard, David; Feuerhak, Kelly; Bharucha, Adil E.
• Is Part Of: Neurogastroenterology & motility. Volume 31:Issue 7(2019)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-04-08
• Subjects: anorectal manometry -- balloon expulsion test -- constipation -- defecatory disorders -- pelvic floor dysfunction; Gastrointestinal system -- Motility -- Periodicals; Gastrointestinal system -- Innervation -- Periodicals; 616.33
• DOI: 10.1111/nmo.13597
• Languages: English
• ISSNs: 1350-1925

Abstract

Abstract: Background: High‐resolution manometry (HRM) is used to measure rectoanal pressures in defecatory disorders and fecal incontinence. This study sought to define normal values for rectoanal HRM, ascertain the effects of age and BMI on rectoanal pressures, and compare pressures in asymptomatic women with normal and prolonged balloon expulsion time (BET). Methods: High‐resolution manometry pressures and BET were measured in 163 asymptomatic healthy participants. Women (96) and men (47) with normal BET were used to estimate normal values and the effects of age/BMI on pressures using a Medtronic 4.2‐mm‐diameter rectoanal catheter. Key Results: Age is associated with lower resting pressure, higher rectal pressure during evacuation, and a higher rectoanal gradient during evacuation in women and men. In women, the BET is also inversely correlated with age while the BMI is correlated with a higher threshold volume for discomfort and a longer BET. The anal squeeze pressure increment, squeeze duration, and HPZ length are higher in men than women. The rectoanal gradient during evacuation is also lower (ie, more negative) in asymptomatic women with an abnormal than a normal BET. Conclusions & Inferences: These findings provide an expanded database of normal values for anorectal HRM in men and women. Age and sex affect anal resting and squeeze pressures, respectively; rectal pressure during evacuation is also higher in older people. Less than 15% of asymptomatic people have BET >60 seconds, which is associated with manometry features of impaired evacuation. Abstract : This study provides an expanded database of normal values for anorectal HRM in men and women. Age and sex affect anal resting and squeeze pressures, respectively. Less than 15% of asymptomatic people have balloon expulsion time >60 seconds, which is associated with manometry features of impaired evacuation.