Manometric, sensorimotor, and neurophysiologic evaluation of anorectal function.

Area of Science:

• Gastroenterology and Neurogastroenterology
• Physiology
• Diagnostic Medicine

Background:

• Symptom-based assessment alone is insufficient for directing therapy in functional bowel disorders.
• Advances in diagnostic technology necessitate a pathophysiology-based approach.
• A robust taxonomy for functional bowel disorders is needed.

Purpose of the Study:

• To highlight the crucial role of physiologic testing in the clinical practice of functional bowel disorders.
• To present the techniques, limitations, measurements, and clinical applications of anorectal function tests.
• To emphasize the impact of these tests on diagnostic yield and management.

Main Methods:

• Review of complementary investigations for anorectal structure and function assessment.
• Presentation of manometric, sensorimotor, and neurophysiologic testing methods.
• Discussion of the clinical utility and limitations of various diagnostic techniques.

Main Results:

• Physiologic testing significantly improves diagnostic yield in functional disorders of evacuation and continence.
• These tests can markedly alter patient management strategies.
• A range of established and complementary investigations are available.

Conclusions:

• Physiologic testing is essential for accurate diagnosis and effective management of functional bowel disorders.
• Anorectal manometry, sensorimotor, and neurophysiologic tests are key components of this diagnostic approach.
• Moving beyond symptom-based evaluation enhances patient care in these conditions.