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The London Classification: Improving Characterization and Classification of Anorectal Function with Anorectal
S Mark Scott1, Emma V Carrington2,3
1Neurogastroenterology Group and GI Physiology Unit, Centre for Neuroscience, Surgery & Trauma, Blizard Institute, Queen Mary University London, London, UK. m.scott@qmul.ac.uk.
Current Gastroenterology Reports
|September 16, 2020
Summary
Standardized anorectal manometry (ARM), rectal sensory testing, and balloon expulsion tests improve diagnosis of anorectal dysfunction. The new London Classification harmonizes these essential clinical investigations for better patient care.
Area of Science:
- Gastroenterology and Hepatology
- Colorectal Surgery
- Physiology
Background:
- Objective measurement of anorectal sensorimotor function is crucial for evaluating patients with intractable anorectal dysfunction.
- Current clinical practice variations limit the utility of established investigations like anorectal manometry (ARM), rectal sensory testing, and the balloon expulsion test.
Purpose of the Study:
- To summarize the International Anorectal Physiology Working Group (IAPWG) consensus and the London Classification of anorectal disorders.
- To provide guidance on indications, equipment, protocols, measurement definitions, and interpretation for ARM, rectal sensory testing, and the balloon expulsion test.
Main Methods:
- Review of recently published IAPWG consensus and London Classification.
- Inclusion of relevant allied literature.
- Focus on office-based investigations for anorectal function.
Main Results:
- The London Classification offers a standardized method and nomenclature for describing alterations in anorectal motor and sensory function.
- Adoption of the London Classification is expected to harmonize clinical practice.
Conclusions:
- Standardized protocols and nomenclature are essential for accurate assessment of anorectal sensorimotor function.
- The London Classification provides a framework for consistent and reliable interpretation of diagnostic tests, improving patient evaluation and management.
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