New Metrics in High-Resolution and High-Definition Anorectal Manometry

  • Myeongsook Seo
  • Segyeong Joo
  • Kee Wook JungEmail author
  • Eun Mi Song
  • Satish S. C. Rao
  • Seung-Jae MyungEmail author
Neurogastroenterology and Motility Disorders of the Gastrointestinal Tract (S Rao, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Neurogastroenterology and Motility Disorders of the Gastrointestinal Tract


Purpose of Review

To review recently published diagnostic methods that use high-resolution (HR-) or high-definition- (HD-) anorectal manometry (ARM) techniques.

Recent Findings

The integrated pressurized volume (IPV) is a new measure based on spatiotemporal plots obtained from HR-ARM. The IPV may be clinically useful for improving the prediction of abnormal balloon expulsion test in patients with constipation and for discriminating patients with anorectal disorders from asymptomatic controls. Combination of IPV parameters was superior to conventional manometric parameters in predicting the responsiveness to biofeedback therapy. Moreover, several novel parameters including the HR-ARM resting integral, HR-ARM squeeze profile, and anorectal asymmetry index may each be useful as predictive factors for identifying patients with fecal incontinence.


HR- and HD-ARM are increasingly performed worldwide for evaluation of anorectal function. Here, we describe new metrics whose clinical significance has not been fully established. Further standardization and validation of these metrics could provide clinically important new information and could help improve our understanding of the pathophysiology of anorectal disorders.


High-resolution anorectal manometry High-definition anorectal manometry Constipation Fecal incontinence 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Myeongsook Seo
    • 1
  • Segyeong Joo
    • 2
  • Kee Wook Jung
    • 3
    Email author
  • Eun Mi Song
    • 3
  • Satish S. C. Rao
    • 4
  • Seung-Jae Myung
    • 3
    Email author
  1. 1.Department of Internal MedicineKonkuk University Chungju HospitalChungjuSouth Korea
  2. 2.Department of Biomedical Engineering, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
  3. 3.Department of Gastroenterology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
  4. 4.Division of Gastroenterology and Hepatology, Department of MedicineAugusta UniversityAugustaUSA

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