Anorectal manometry

Anorectal manometry
Diagram of anus, rectum, interior sphincter and exterior sphincter
Diagram of the anorectum. This is the location where the probe is inserted and where pressures are measured.
OPS-301 code1-315

Anorectal manometry (ARM) is a medical test used to measure pressures in the anus and rectum and to assess their function.[1][2] The test is performed by inserting a catheter, that contains a probe embedded with pressure sensors, through the anus and into the rectum.[3] Patients may be asked to perform certain maneuvers, such as coughing or attempting to defecate, to assess for pressure changes.[3] Anorectal manometry is a safe[4] and low risk[3] procedure.

From 2014 to 2018, the international anorectal physiology working group (IAPWG) meet several times to develop consensus on indications for anorectal manometry.[5] Their assessment concluded that anorectal manometry was indicated when used in assessment of fecal incontinence, constipation, evacuation disorders (including Hirschsprung's disease[6]), functional anorectal pain and in the assessment of anorectal function preoperatively or after a traumatic obstetric injury.[5] In addition to the indications outlined by the IAPWG, anorectal manometry has been used as a component of anorectal biofeedback.[6]

Since its introduction in 2007, high resolution anorectal manometry (HR-ARM) has increasingly replaced conventional anorectal manometry as the standard.[7] There has been increasing usage of high-definition (3D) anorectal manometry (HD-ARM) as well.[7] Current advances in anorectal manometry include the development of bedside portable technology.[7]

  1. ^ Cash BD (15 September 2008). Curbside Consultation of the Colon: 49 Clinical Questions. SLACK Incorporated. pp. 67–. ISBN 978-1-55642-831-9. Retrieved 10 November 2010.
  2. ^ Craft TM, Parr MJ, Nolan JP (2004-11-10). Key Topics in Critical Care, Second Edition. CRC Press. p. 1011. ISBN 9781841843582.
  3. ^ a b c Lee TH, Bharucha AE (January 2016). "How to Perform and Interpret a High-resolution Anorectal Manometry Test". Journal of Neurogastroenterology and Motility. 22 (1): 46–59. doi:10.5056/jnm15168. PMC 4699721. PMID 26717931.
  4. ^ Heinrich H, Misselwitz B (April 2018). "High-Resolution Anorectal Manometry - New Insights in the Diagnostic Assessment of Functional Anorectal Disorders". Visceral Medicine. 34 (2): 134–139. doi:10.1159/000488611. PMC 5981680. PMID 29888243.
  5. ^ a b Carrington EV, Heinrich H, Knowles CH, Fox M, Rao S, Altomare DF, et al. (January 2020). "The international anorectal physiology working group (IAPWG) recommendations: Standardized testing protocol and the London classification for disorders of anorectal function". Neurogastroenterology and Motility. 32 (1): e13679. doi:10.1111/nmo.13679. PMC 6923590. PMID 31407463.
  6. ^ a b Basilisco G, Bharucha AE (August 2017). "High-resolution anorectal manometry: An expensive hobby or worth every penny?". Neurogastroenterology and Motility. 29 (8): e13125. doi:10.1111/nmo.13125. PMC 5609826. PMID 28699318.
  7. ^ a b c Scott SM, Carrington EV (September 2020). "The London Classification: Improving Characterization and Classification of Anorectal Function with Anorectal Manometry". Current Gastroenterology Reports. 22 (11): 55. doi:10.1007/s11894-020-00793-z. PMC 7497505. PMID 32935278.