High-resolution anorectal manometry: An expensive hobby or worth every penny?

Area of Science:

• Gastroenterology
• Physiology

Background:

• High-resolution manometry (HRM) has advanced anorectal manometry techniques.
• The American Gastroenterological Association (AGA) last updated its position statement on anorectal testing in 1999.

Purpose of the Study:

• To review the methods, clinical indications, utility, and pitfalls of anorectal manometry.
• To re-evaluate the 1999 AGA position statement in light of HRM.

Main Methods:

• Review of existing literature and clinical practice regarding anorectal manometry.
• Comparison of HRM capabilities with previous manometry techniques.

Main Results:

• HRM provides refined anorectal pressure profiles and reduces artifacts, aiding in identifying structural abnormalities or anal weakness.
• Many abnormal manometry patterns are also found in healthy individuals, limiting diagnostic utility for defecatory disorders.
• The core conclusions of the 1999 AGA statement remain valid.

Conclusions:

• HRM has not significantly increased publications or altered management of anorectal disorders.
• Standardization efforts for HRM are ongoing and necessary.
• Further research and catheter improvements are required to establish the definitive clinical value and cost-effectiveness of HRM.