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Published on: April 17, 2019
Values From Three-dimensional High-resolution Anorectal Manometry Analysis of Children Without Lower
Marcin Banasiuk1, Aleksandra Banaszkiewicz1, Marcin Dziekiewicz1
1Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland.
Insights
This study establishes normal three-dimensional high-resolution anorectal manometry (3DHRAM) values in children. Findings show no significant differences in pressure parameters across different age groups or sexes.
Area of Science:
- Pediatric Gastroenterology
- Anorectal Physiology
- Diagnostic Imaging
Background:
- Three-dimensional high-resolution anorectal manometry (3DHRAM) offers detailed pressure mapping of the anal canal.
- Establishing normative data is crucial for accurate interpretation of 3DHRAM in pediatric populations.
Purpose of the Study:
- To determine normal three-dimensional high-resolution anorectal manometry (3DHRAM) values in a pediatric cohort.
- To assess the correlation of these values with age and sex in children.
Main Methods:
- A prospective study involving 61 asymptomatic children was conducted.
- 3DHRAM was performed using a rigid probe to measure anal canal pressure and sphincter dynamics.
- Squeeze pressures and sensory thresholds were evaluated, with data stratified by age groups.
Main Results:
- Mean resting and squeeze sphincter pressures were 83 ± 23 mm Hg and 191 ± 64 mm Hg, respectively.
- Anal canal length correlated with age (r=0.49, P < .0001).
- No significant differences in pressure parameters were found between age groups or sexes.
Conclusions:
- This study provides normative 3DHRAM values for children.
- Age and sex do not significantly influence key pressure parameters in pediatric 3DHRAM.
- These findings aid in the clinical interpretation of anorectal manometry in pediatric patients.
Background & Aims:
Three-dimensional high-resolution anorectal manometry (3DHRAM) provides a topographic image of pressure along the anal canal. We aimed to determine normal 3DHRAM values in children.
Methods:
We performed a prospective study of 61 children (34 male; mean age, 8.28 years) without any symptoms arising from the lower gastrointestinal tract who were evaluated at the Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Poland. Manometry procedures were performed by using a rigid probe without medication. Pressure within the anal canal and 3D images of sphincters were measured. If possible, squeeze pressure and thresholds of sensation were evaluated. The population was divided into age groups of <5 years, 5-8 years, 9-12 years, and older than 12 years.
Results:
The mean resting and squeeze sphincter pressures were 83 ± 23 mm Hg and 191 ± 64 mm Hg, respectively. The mean length of the anal canal was 2.62 ± 0.68 cm and correlated with age (r = 0.49, P < .0001). The mean rectal balloon volume to elicit rectoanal inhibitory reflex was 15.7 ± 10.9 cm(3). The first sensation, urge, and discomfort were observed at balloon volumes of 24.4 ± 23.98 cm(3), 45.9 ± 34.55 cm(3), and 91.6 ± 50.17 cm(3), respectively. The mean resting pressure of the puborectalis muscle was 69 ± 14 mm Hg, whereas the mean squeeze pressure was 124 ± 33 mm Hg. There was no statistically significant difference in pressure parameters between age groups. We observed a positive correlation between age and balloon volume needed to elicit discomfort (r = 0.49, P < .001).
Conclusions:
In a prospective study, we determined normal values from 3DHRAM analysis of children without symptoms arising from the lower gastrointestinal tract. There were no significant differences in pressure results between children of different sexes or ages. ClinicalTrials.gov number: NCT02236507.
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