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MANOMETRIC ASSESSMENT OF ANORECTAL FUNCTION - 03/09/11

Doi : 10.1016/S0889-8553(05)70165-5 
Wei Ming Sun, MD, PhD a, Satish S.C. Rao, MD, PhD, FRCP(Lon) b
a Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan (WMS) 
b Section of Neurogastroenterology, Division of Gastroenterology-Hepatology, Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, Iowa (SSCR) 

Resumen

The anorectum plays an important role in the regulation of defecation and in the maintenance of continence.2, 32In the 1980s and 1990s, a wide range of tests were developed to assess anorectal function.32 The most common and widely used test is anorectal manometry.2, 32The American Gastroenterological Association2 has endorsed this technique but has recognized that “it requires some degree of experience and familiarity with the test and its applications.” The position paper further acknowledged that there was a lack of consensus regarding which test to use and when.2 This lack of consensus was confirmed in a multicenter study that compared current methods of performing anorectal manometry. In 7 centers across North America and Europe, no 2 centers used a similar probe, similar sensor configuration, or similar methodology.24

This article reviews some of the tests that commonly are used for assessing anorectal and pelvic floor function, assesses the significance of these tests, and provides an approach for the manometric assessment of anorectal function. Tests for assessing anorectal function include the following:

Tests commonly performed
Anorectal manometry
Anal endosonography
Sphincter electromyography
Object expulsion test
Defecography
Saline continence test
Pudendal nerve terminal motor latency
Tests performed in research laboratories
Rectal barostat
Anal vectorgraphy
Rectoanal scintigraphy
Ambulatory anorectal manometry
MR imaging
Videofluorodefecometry

Each laboratory should develop its own normal range for interpreting results or if using normative data from the literature to adopt similar methodology. The reader is referred to Olsen's article in this issue for a discussion on neurophysiologic assessment of anorectal function. The present article focuses primarily on the manometric and sensory assessment of anorectal function.

The purpose of anorectal manometry is to evaluate the integrated function of the defecation unit, including its motor and sensory function. From these measurements, it is possible to assess the expulsion forces, the resistance to bowel evacuation, the anorectal sensory responses, and the neuronal innervation.

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 Address reprint requests to Wei Ming Sun, MD, PhD Division of Gastroenterology Department of Internal Medicine University of Michigan 3912 Taubman Center Ann Arbor, MI 48109 e-mail: sunwm@umich.edu


© 2001  W. B. Saunders Company. Publicado por Elsevier Masson SAS. Todos los derechos reservados.© 1997  © 1997 
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Vol 30 - N° 1

P. 15-32 - mars 2001 Regresar al número
Artículo precedente Artículo precedente
  • ANORECTAL ANATOMY AND PHYSIOLOGY
  • Philip H. Gordon
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  • CLINICAL NEUROPHYSIOLOGY AND ELECTRODIAGNOSTIC TESTING OF THE PELVIC FLOOR
  • Ambre L. Olsen, Satish S.C. Rao

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