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Related Concept Videos

Assessment of the Rectum and Anus01:25

Assessment of the Rectum and Anus

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Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
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Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy01:26

Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy

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This lesson explores three gastrointestinal imaging techniques: radionuclide testing, colonic transit studies, and virtual colonoscopy.
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In gastric emptying studies, a meal's liquid and...
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Drugs for Treatment of Constipation-Predominant IBS01:21

Drugs for Treatment of Constipation-Predominant IBS

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Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
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Lower GI Series: Barium Enema01:23

Lower GI Series: Barium Enema

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A Barium Enema, or a lower GI series, is a specialized radiographic examination designed to visualize the lower gastrointestinal tract, specifically the colon and rectum. This procedure is instrumental in diagnosing various conditions such as colorectal cancer, polyps, diverticulosis, and inflammatory bowel disease.
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The examination begins by inserting a lubricated rectal tube into the patient's rectum to administer a radiopaque barium solution. The barium flow is carefully...
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Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation01:30

Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation

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Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
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Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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Related Experiment Video

Updated: Jun 8, 2025

Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
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High-Resolution Anorectal Manometry and Balloon Expulsion Test Outcomes in Functional Constipation: A Comparative

Huihui Shi1, Li Li1, Ling Huang1

  • 1Department of Gastroenterology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China.

Medical Science Monitor : International Medical Journal of Experimental and Clinical Research
|November 7, 2024
PubMed
Summary

High-resolution anorectal manometry (HRAM) and balloon expulsion test (BET) effectively assess functional constipation. BET showed higher specificity than HRAM in diagnosing dyssynergic defecation, with male sex and incomplete evacuation sensation being key risk factors.

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Area of Science:

  • Gastroenterology
  • Physiology

Background:

  • Functional constipation presents with difficult, infrequent, or painful bowel movements, sometimes with incomplete evacuation, affecting both children and adults.
  • Idiopathic causes are common, necessitating accurate diagnostic tools for effective management.

Purpose of the Study:

  • To compare the diagnostic findings of high-resolution anorectal manometry (HRAM) and the balloon expulsion test (BET) in patients with functional constipation.
  • To establish normative values for anorectal pressures using HRAM and identify risk factors for dyssynergic defecation.

Main Methods:

  • A comparative study involving 360 patients with functional constipation and 73 healthy volunteers.
  • Data collection included general participant information, defecation symptom surveys, and performance of both HRAM and BET procedures.
  • Logistic regression analysis was employed to identify predictors of dyssynergic defecation.

Main Results:

  • No significant age-related correlation was found for HRAM results in healthy volunteers.
  • Men exhibited higher residual anal pressure and anal squeeze pressure, and a lower rectoanal pressure gradient compared to women.
  • Male sex (OR=2.880) and sensation of incomplete evacuation (OR=1.892) were identified as significant risk factors for dyssynergic defecation.
  • The specificity of BET for diagnosing dyssynergic defecation was 81.89%, compared to 52.78% for HRAM.

Conclusions:

  • HRAM provides essential normative data for anorectal pressures.
  • Both HRAM and BET are validated and effective diagnostic modalities for evaluating functional constipation.
  • The balloon expulsion test demonstrates superior specificity in diagnosing dyssynergic defecation compared to high-resolution anorectal manometry.