Diagnostic Strategy and Tools for Identifying Defecatory Disorders - 05/02/22

Doi : 10.1016/j.gtc.2021.10.002

Adil E. Bharucha, MBBS, MD ^a,^⁎ , Enrique Coss-Adame, MD ^b,^{^{1
Present address: Ocaso 51, Interior 105, Col Insurgentes Cuicuilco, Coyoacán, CDMX, Mexico, CP 04530.}}
^a Division of Gastroenterology and Hepatology, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA
^b Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, México City, Mexico

^∗Corresponding author. Division of Gastroenterology and Hepatology, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA.Division of Gastroenterology and HepatologyMayo Clinic200 1st Street SWRochesterMN55905USA

Résumé

This article reviews the indications, techniques, interpretation, strengths, and weaknesses of tests (anal manometry, anal surface electromyography, rectal balloon expulsion test, barium and MRI defecography, assessment of rectal compliance and sensation, and colonic transit) that are used diagnose defecatory disorders in constipated patients. The selection of tests and the sequence in which they are performed should be individualized to and interpreted in the context of the clinical features. Because anorectal functions are affected by age, results should be interpreted with reference to age- and sex-matched normal values for the same technique.

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Keywords : High-resolution anorectal manometry, MRI, Biofeedback therapy, Constipation, Anal sphincter