Skip to main content

Abstract

High-resolution anorectal manometry is a technique that allows dynamic assessment of pelvic floor muscles, particularly the puborectalis muscle of the levator ani complex and the internal and external anal sphincters. These muscles are assessed both during rest and during certain maneuvers. The principle of anorectal manometry is similar to that of the esophageal manometry.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Lee YY, Erdogan A, Yu S, Dewitt A, Rao SSC. Anorectal manometry in defecatory disorders: a comparative analysis of high-resolution pressure topography and waveform manometry. J Neurogastroenterol Motil. 2018;24:460–8.

    Article  Google Scholar 

  2. Rao SSC. Rectal exam: yes, it can and should be done in a busy practice! Am J Gastroenterol. 2018;113:635–8.

    Article  Google Scholar 

  3. Rao SS, Azpiroz F, Diamant N, Enck P, Tougas G, Wald A. Minimum standards of anorectal manometry. Neurogastroenterol Motil. 2002;14:553–9.

    Article  CAS  Google Scholar 

  4. Shah ED, Farida JD, Menees S, Baker JR, Chey WD. Examining balloon expulsion testing as an office-based, screening test for dyssynergic defecation: a systematic review and meta-analysis. Am J Gastroenterol. 2018;113:1613–20.

    Article  Google Scholar 

  5. Rao SS, Hasler WL. Can high-resolution anorectal manometry shed new light on defecatory disorders? Gastroenterology. 2013;144:263–5.

    Article  Google Scholar 

  6. Rezaie A, Gu P, Kaplan GG, Pimentel M, Al-Darmaki AK. Dyssynergic defecation in inflammatory bowel disease: a systematic review and meta-analysis. Inflamm Bowel Dis. 2018;24:1065–73.

    Article  Google Scholar 

  7. Bharucha AE. Pelvic floor: anatomy and function. Neurogastroenterol Motil. 2006;18:507–19.

    Article  CAS  Google Scholar 

  8. Carrington EV, Brokjaer A, Craven H, Zarate N, Horrocks EJ, Palit S, et al. Traditional measures of normal anal sphincter function using high-resolution anorectal manometry (HRAM) in 115 healthy volunteers. Neurogastroenterol Motil. 2014;26:625–35.

    Article  CAS  Google Scholar 

  9. Opazo A, Aguirre E, Saldana E, Fantova MJ, Clave P. Patterns of impaired internal anal sphincter activity in patients with anal fissure. Colorectal Dis. 2013;15:492–9.

    Article  CAS  Google Scholar 

  10. Lee HJ, Jung KW, Han S, Kim JW, Park SK, Yoon IJ, et al. Normal values for high-resolution anorectal manometry/topography in a healthy Korean population and the effects of gender and body mass index. Neurogastroenterol Motil. 2014;26:529–37.

    Article  CAS  Google Scholar 

  11. Azpiroz F, Enck P, Whitehead WE. Anorectal functional testing: review of collective experience. Am J Gastroenterol. 2002;97:232–40.

    PubMed  Google Scholar 

  12. Fox M, Schwizer W, Menne D, Stutz B, Fried M, Thumshirn M. The physical properties of rectal contents have effects on anorectal continence: insights from a study into the cause of fecal spotting on orlistat. Dis Colon Rectum. 2004;47:2147–56.

    Article  Google Scholar 

  13. Miller R, Bartolo DC, Cervero F, Mortensen NJ. Anorectal sampling: a comparison of normal and incontinent patients. Br J Surg. 1988;75:44–7.

    Article  CAS  Google Scholar 

  14. Sangwan YP, Solla JA. Internal anal sphincter: advances and insights. Dis Colon Rectum. 1998;41:1297–311.

    Article  CAS  Google Scholar 

  15. Ratuapli SK, Bharucha AE, Noelting J, Harvey DM, Zinsmeister AR. Phenotypic identification and classification of functional defecatory disorders using high-resolution anorectal manometry. Gastroenterology. 2013;144:314–22 e2.

    Article  Google Scholar 

  16. Sauter M, Heinrich H, Fox M, Misselwitz B, Halama M, Schwizer W, et al. Toward more accurate measurements of anorectal motor and sensory function in routine clinical practice: validation of high-resolution anorectal manometry and Rapid Barostat Bag measurements of rectal function. Neurogastroenterol Motil. 2014;26:685–95.

    Article  CAS  Google Scholar 

  17. Mulak A, Paradowski L. Anorectal function and dyssynergic defecation in different subgroups of patients with irritable bowel syndrome. Int J Colorectal Dis. 2010;25:1011–6.

    Article  Google Scholar 

  18. Rezaie A. Methane on breath test predicts altered rectal sensation during high resolution anorectal manometry. Gastroenterology. 2014;146:S-721.

    Article  Google Scholar 

  19. Shin JK, Cheon JH, Kim ES, Yoon JY, Lee JH, Jeon SM, et al. Predictive capability of anorectal physiologic tests for unfavorable outcomes following biofeedback therapy in dyssynergic defecation. J Korean Med Sci. 2010;25:1060–5.

    Article  Google Scholar 

  20. Previnaire JG. The importance of the bulbocavernosus reflex. Spinal Cord Ser Cases. 2018;4:2.

    Article  Google Scholar 

  21. Rao SS, Read NW, Stobart JA, Haynes WG, Benjamin S, Holdsworth CD. Anorectal contractility under basal conditions and during rectal infusion of saline in ulcerative colitis. Gut. 1988;29:769–77.

    Article  CAS  Google Scholar 

  22. Eckardt VF, Schmitt T, Bernhard G. Anal ultra slow waves: a smooth muscle phenomenon associated with dyschezia. Dig Dis Sci. 1997;42:2439–45.

    Article  CAS  Google Scholar 

  23. Rao SS, Tuteja AK, Vellema T, Kempf J, Stessman M. Dyssynergic defecation: demographics, symptoms, stool patterns, and quality of life. J Clin Gastroenterol. 2004;38:680–5.

    Article  Google Scholar 

  24. Rao SS, Welcher KD, Leistikow JS. Obstructive defecation: a failure of rectoanal coordination. Am J Gastroenterol. 1998;93:1042–50.

    Article  CAS  Google Scholar 

  25. Henry MM, Parks AG, Swash M. The pelvic floor musculature in the descending perineum syndrome. Br J Surg. 1982;69:470–2.

    Article  CAS  Google Scholar 

  26. Parks AG, Porter NH, Hardcastle J. The syndrome of the descending perineum. Proc R Soc Med. 1966;59:477–82.

    CAS  PubMed  PubMed Central  Google Scholar 

  27. Harewood GC, Coulie B, Camilleri M, Rath-Harvey D, Pemberton JH. Descending perineum syndrome: audit of clinical and laboratory features and outcome of pelvic floor retraining. Am J Gastroenterol. 1999;94:126–30.

    Article  CAS  Google Scholar 

  28. Pezim ME, Pemberton JH, Levin KE, Litchy WJ, Phillips SF. Parameters of anorectal and colonic motility in health and in severe constipation. Dis Colon Rectum. 1993;36:484–91.

    Article  CAS  Google Scholar 

  29. Rezaie A, Iriana S, Pimentel M, Murrell Z, Fleshner P, Zaghiyan K. Can three-dimensional high-resolution anorectal manometry detect anal sphincter defects in patients with faecal incontinence? Colorectal Dis. 2017;19(5):468–75.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Moosavi, S., Rezaie, A., Pimentel, M., Pichetshote, N. (2020). Anorectal Manometry. In: Atlas of High-Resolution Manometry, Impedance, and pH Monitoring. Springer, Cham. https://doi.org/10.1007/978-3-030-27241-8_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-27241-8_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-27240-1

  • Online ISBN: 978-3-030-27241-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics