Diagnostic Accuracy of Anorectal Manometry in Identifying Dyssynergic Defecation among Chronic Constipation Patients
Anuradha Dnyanmote1, Veerla Siddharth1, Amol Dahale2
1Department of General Surgery, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India.
Background:
Dyssynergic defecation (DD) is a common yet underdiagnosed subtype of chronic constipation, often refractory to conventional treatment. Anorectal manometry (ARM) is a valuable physiological tool for identifying neuromuscular abnormalities contributing to DD.
Objective:
This study aimed to assess the diagnostic accuracy of ARM in detecting DD among patients with chronic constipation.
Materials And Methods:
A prospective observational study was conducted at Dr. D. Y. Patil Medical College, Pune, between January 2023 and February 2025, involving 102 patients with chronic constipation unresponsive to laxatives and lifestyle changes. Patients underwent high-resolution ARM and balloon expulsion test (BET). Dyssynergic patterns were classified using Rao's criteria. Data were analyzed using SPSS v26.0.
Results:
Among the participants (mean age 45.53 ± 13.3 years), 75.5% were diagnosed with DD via ARM. The most prevalent manometric subtype was Type IV (28.4%), followed by Type I (21.6%). ARM demonstrated high diagnostic accuracy with a sensitivity of 97.4%, specificity of 88.5%, and overall accuracy of 95.1% when compared with BET.
Conclusion:
ARM is a reliable diagnostic modality for evaluating functional defecatory disorders. Incorporating ARM into routine evaluation of chronic constipation, especially when empirical therapies fail, can significantly enhance diagnostic precision and guide targeted interventions such as biofeedback therapy.
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