Reproducibility of high-resolution manometry among healthy and constipated persons.
London classification
constipation
defecation
dyssynergic defecation
pelvic floor dysfunction
Journal
Neurogastroenterology and motility
ISSN: 1365-2982
Titre abrégé: Neurogastroenterol Motil
Pays: England
ID NLM: 9432572
Informations de publication
Date de publication:
12 2022
12 2022
Historique:
revised:
30
06
2022
received:
27
04
2022
accepted:
14
07
2022
pubmed:
27
8
2022
medline:
6
12
2022
entrez:
26
8
2022
Statut:
ppublish
Résumé
Although high-resolution manometry (HR_ARM) is commonly used to diagnose defecatory disorders, its intraindividual day-to-day reproducibility is unknown. Since these measurements entail voluntary effort, this study aimed to evaluate the intraindividual day-to-day reproducibility of HR_ARM. In 22 healthy women (35 years [14] mean [SD]) and 53 constipated patients (42 years [13], 46 women), the rectal balloon expulsion time (BET), and anorectal pressures were measured with HR_ARM on 2 days separated by a median (interquartile range) of 15 days (11-53) in healthy and 40 days (8-75) in constipated patients. Anorectal pressures were evaluated at rest (20 s), during squeeze, and during evacuation. Rectal sensation was also evaluated in constipated patients. The agreement between both measurements was evaluated with Lin's concordance correlation coefficient (CCC) and other tests. Among constipated patients, the anal resting (mean CCC [95%CI] 0.62 [0.43-0.76]) and squeeze pressures (CCC 0.65 [0.47-0.79]), rectoanal gradient during evacuation (CCC 0.42 [0.17-0.62]), and rectal sensory thresholds (CCC for urgency 0.72 [0.52-0.84]) were concordant. Between days 1 and 2, one or more outcomes, characterized as normal or abnormal, differed in 79% of constipated patients, i.e., anal resting and squeeze pressures, the gradient, and the rectal BET differed in, respectively, 25%, 19%, 36%, and 10% of constipated patients. The rectal BET was prolonged in three healthy persons (both days) and either on 1 day (six patients) or 2 days (33 patients) in constipated patients. While HR_ARM variables and the BET are reproducible within healthy and constipated persons, the outcome on repeat testing differed in 79% of constipated patients.
Sections du résumé
BACKGROUND AND AIMS
Although high-resolution manometry (HR_ARM) is commonly used to diagnose defecatory disorders, its intraindividual day-to-day reproducibility is unknown. Since these measurements entail voluntary effort, this study aimed to evaluate the intraindividual day-to-day reproducibility of HR_ARM.
METHODS
In 22 healthy women (35 years [14] mean [SD]) and 53 constipated patients (42 years [13], 46 women), the rectal balloon expulsion time (BET), and anorectal pressures were measured with HR_ARM on 2 days separated by a median (interquartile range) of 15 days (11-53) in healthy and 40 days (8-75) in constipated patients. Anorectal pressures were evaluated at rest (20 s), during squeeze, and during evacuation. Rectal sensation was also evaluated in constipated patients. The agreement between both measurements was evaluated with Lin's concordance correlation coefficient (CCC) and other tests.
RESULTS
Among constipated patients, the anal resting (mean CCC [95%CI] 0.62 [0.43-0.76]) and squeeze pressures (CCC 0.65 [0.47-0.79]), rectoanal gradient during evacuation (CCC 0.42 [0.17-0.62]), and rectal sensory thresholds (CCC for urgency 0.72 [0.52-0.84]) were concordant. Between days 1 and 2, one or more outcomes, characterized as normal or abnormal, differed in 79% of constipated patients, i.e., anal resting and squeeze pressures, the gradient, and the rectal BET differed in, respectively, 25%, 19%, 36%, and 10% of constipated patients. The rectal BET was prolonged in three healthy persons (both days) and either on 1 day (six patients) or 2 days (33 patients) in constipated patients.
CONCLUSIONS
While HR_ARM variables and the BET are reproducible within healthy and constipated persons, the outcome on repeat testing differed in 79% of constipated patients.
Identifiants
pubmed: 36017816
doi: 10.1111/nmo.14438
pmc: PMC9722563
mid: NIHMS1828433
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14438Subventions
Organisme : NIDDK NIH HHS
ID : R01 DK078924
Pays : United States
Informations de copyright
© 2022 John Wiley & Sons Ltd.
Références
Gastroenterology. 2016 Mar 25;:
pubmed: 27144630
Neurogastroenterol Motil. 2013 Mar;25(3):230-7, e163
pubmed: 23130678
Gastroenterology. 2020 Apr;158(5):1232-1249.e3
pubmed: 31945360
Neurogastroenterol Motil. 2017 Mar;29(3):
pubmed: 27696628
Clin Gastroenterol Hepatol. 2015 Jun;13(6):1143-50.e1
pubmed: 25616028
Neurogastroenterol Motil. 2019 Jun;31(6):e13591
pubmed: 31094054
Neurogastroenterol Motil. 2022 Sep;34(9):e14341
pubmed: 35238445
Dig Dis Sci. 2022 Nov;67(11):5014-5018
pubmed: 35194706
Am J Gastroenterol. 2021 Oct 1;116(10):1987-2008
pubmed: 34618700
Neurogastroenterol Motil. 2020 Oct;32(10):e13910
pubmed: 32613711
Clin Gastroenterol Hepatol. 2014 Dec;12(12):2049-54
pubmed: 24674941
Neurogastroenterol Motil. 2022 Oct;34(10):e14383
pubmed: 35468247
Gastroenterology. 2022 Apr;162(4):1111-1122.e2
pubmed: 34951994
Gastroenterology. 2022 Dec;163(6):1582-1592.e2
pubmed: 35995074
Neurogastroenterol Motil. 2022 Sep;34(9):e14335
pubmed: 35220645
Neurogastroenterol Motil. 2019 Jul;31(7):e13597
pubmed: 30957382
Clin Gastroenterol Hepatol. 2019 May;17(6):1138-1147.e3
pubmed: 30130627
Neurogastroenterol Motil. 2020 Jan;32(1):e13679
pubmed: 31407463
Clin Gastroenterol Hepatol. 2022 Sep;20(9):2091-2101.e5
pubmed: 34896282