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Published in: BMC Gastroenterology 1/2021

Open Access 01-12-2021 | Research

Normal values for high-resolution anorectal manometry in healthy young adults: evidence from Vietnam

Authors: Le Manh Cuong, Ha Van Quyet, Tran Manh Hung, Nguyen Ngoc Anh, Tran Thu Ha, Vu Van Du, Do Van Loi, Ha Huu Hoang Khai, Vu Duy Kien

Published in: BMC Gastroenterology | Issue 1/2021

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Abstract

Background

High-resolution anorectal manometry (HRAM) has been developed to improve measurement of anorectal functions. This study aims to identify normal HRAM values in healthy young Vietnamese adults.

Methods

We conducted a cross-sectional study at the National Hospital of Traditional Medicine (Hanoi, Vietnam) from July through December 2014. Healthy young adults were invited to participate in the study. All anorectal measurement values were performed using the ISOLAB high-resolution manometry system. Differences between groups were analyzed using Student’s t-tests.

Results

Thirty healthy young adults, including 15 males and 15 females aged 19–26 years, were recruited. Mean functional anal canal length was 3.4 ± 0.5 cm (range: 2.4–4.8 mm). Mean maximum resting pressure, mean maximum squeezing pressure, mean maximum coughing pressure, and mean maximum strain pressure were 65.5, 168.0, 125.9, and 84.2 mm Hg, respectively. All anal pressure values were significantly different between males and females. For rectal sensation measurements, only the volume at first sensation was significantly higher in males than in females.

Conclusions

This study provides normal HRAM value for healthy young adults in Vietnam. Sex may influence anal pressure and first rectal sensation values in this cohort. Further studies should be conducted in order to improve the quality of HRAM normal values and to confirm the effects of sex.
Literature
1.
go back to reference Azpiroz F, Enck P, Whitehead WE. Anorectal functional testing: review of collective experience. Am J Gastroenterol. 2002;97(2):232–40.PubMed Azpiroz F, Enck P, Whitehead WE. Anorectal functional testing: review of collective experience. Am J Gastroenterol. 2002;97(2):232–40.PubMed
2.
go back to reference Lee TH, Bharucha AE. How to perform and interpret a high-resolution anorectal manometry test. J Neurogastroenterol Motil. 2016;22(1):46–59.CrossRef Lee TH, Bharucha AE. How to perform and interpret a high-resolution anorectal manometry test. J Neurogastroenterol Motil. 2016;22(1):46–59.CrossRef
3.
go back to reference Rao SS. Pathophysiology of adult fecal incontinence. Gastroenterology. 2004;126(1 Suppl 1):S14-22.PubMed Rao SS. Pathophysiology of adult fecal incontinence. Gastroenterology. 2004;126(1 Suppl 1):S14-22.PubMed
4.
go back to reference Lunniss PJ, Gladman MA, Hetzer FH, Williams NS, Scott SM. Risk factors in acquired faecal incontinence. J R Soc Med. 2004;97(3):111–6.CrossRef Lunniss PJ, Gladman MA, Hetzer FH, Williams NS, Scott SM. Risk factors in acquired faecal incontinence. J R Soc Med. 2004;97(3):111–6.CrossRef
5.
go back to reference Diamant NE, Kamm MA, Wald A, Whitehead WE. AGA technical review on anorectal testing techniques. Gastroenterology. 1999;116(3):735–60.CrossRef Diamant NE, Kamm MA, Wald A, Whitehead WE. AGA technical review on anorectal testing techniques. Gastroenterology. 1999;116(3):735–60.CrossRef
6.
go back to reference Scott SM, Gladman MA. Manometric, sensorimotor, and neurophysiologic evaluation of anorectal function. Gastroenterol Clin North Am. 2008;37(3):511–38 vii.CrossRef Scott SM, Gladman MA. Manometric, sensorimotor, and neurophysiologic evaluation of anorectal function. Gastroenterol Clin North Am. 2008;37(3):511–38 vii.CrossRef
7.
go back to reference Carrington EV, Scott SM, Bharucha A, Mion F, Remes-Troche JM, Malcolm A, Heinrich H, Fox M, Rao SS, International Anorectal Physiology Working G, et al. Expert consensus document: advances in the evaluation of anorectal function. Nat Rev Gastroenterol Hepatol. 2018;15(5):309–23.CrossRef Carrington EV, Scott SM, Bharucha A, Mion F, Remes-Troche JM, Malcolm A, Heinrich H, Fox M, Rao SS, International Anorectal Physiology Working G, et al. Expert consensus document: advances in the evaluation of anorectal function. Nat Rev Gastroenterol Hepatol. 2018;15(5):309–23.CrossRef
8.
go back to reference Carrington EV, Brokjaer A, Craven H, Zarate N, Horrocks EJ, Palit S, Jackson W, Duthie GS, Knowles CH, Lunniss PJ, et al. Traditional measures of normal anal sphincter function using high-resolution anorectal manometry (HRAM) in 115 healthy volunteers. Neurogastroenterol Motil. 2014;26(5):625–35.CrossRef Carrington EV, Brokjaer A, Craven H, Zarate N, Horrocks EJ, Palit S, Jackson W, Duthie GS, Knowles CH, Lunniss PJ, et al. Traditional measures of normal anal sphincter function using high-resolution anorectal manometry (HRAM) in 115 healthy volunteers. Neurogastroenterol Motil. 2014;26(5):625–35.CrossRef
9.
go back to reference Jung KW, Joo S, Yang DH, Yoon IJ, Seo SY, Kim SO, Lee J, Lee HJ, Kim KJ, Ye BD. A novel high-resolution anorectal manometry parameter based on a three‐dimensional integrated pressurized volume of a spatiotemporal plot, for predicting balloon expulsion in asymptomatic normal individuals. Neurogastroenterol Motility. 2014;26(7):937–49.CrossRef Jung KW, Joo S, Yang DH, Yoon IJ, Seo SY, Kim SO, Lee J, Lee HJ, Kim KJ, Ye BD. A novel high-resolution anorectal manometry parameter based on a three‐dimensional integrated pressurized volume of a spatiotemporal plot, for predicting balloon expulsion in asymptomatic normal individuals. Neurogastroenterol Motility. 2014;26(7):937–49.CrossRef
10.
go back to reference Lee HJ, Jung KW, Han S, Kim JW, Park SK, Yoon IJ, Koo HS, Seo SY, Yang DH, Kim KJ, et al. Normal values for high-resolution anorectal manometry/topography in a healthy Korean population and the effects of gender and body mass index. Neurogastroenterol Motil. 2014;26(4):529–37.CrossRef Lee HJ, Jung KW, Han S, Kim JW, Park SK, Yoon IJ, Koo HS, Seo SY, Yang DH, Kim KJ, et al. Normal values for high-resolution anorectal manometry/topography in a healthy Korean population and the effects of gender and body mass index. Neurogastroenterol Motil. 2014;26(4):529–37.CrossRef
11.
go back to reference Li Y, Yang X, Xu C, Zhang Y, Zhang X. Normal values and pressure morphology for three-dimensional high-resolution anorectal manometry of asymptomatic adults: a study in 110 subjects. Int J Colorectal Dis. 2013;28(8):1161–8.CrossRef Li Y, Yang X, Xu C, Zhang Y, Zhang X. Normal values and pressure morphology for three-dimensional high-resolution anorectal manometry of asymptomatic adults: a study in 110 subjects. Int J Colorectal Dis. 2013;28(8):1161–8.CrossRef
12.
go back to reference Noelting J, Ratuapli SK, Bharucha AE, Harvey DM, Ravi K, Zinsmeister AR. Normal values for high-resolution anorectal manometry in healthy women: effects of age and significance of rectoanal gradient. Am J Gastroenterol. 2012;107(10):1530–6.CrossRef Noelting J, Ratuapli SK, Bharucha AE, Harvey DM, Ravi K, Zinsmeister AR. Normal values for high-resolution anorectal manometry in healthy women: effects of age and significance of rectoanal gradient. Am J Gastroenterol. 2012;107(10):1530–6.CrossRef
13.
go back to reference Cuong LM, Nam V, Ha TT, Ha TT, Hung TQ, Van Loi D, Hung TM, Van Son N, Kien VD. Anorectal functional outcomes following Doppler-guided transanal hemorrhoidal dearterialization: evidence from Vietnam. Adv Ther. 2020;37(3):1136–44.CrossRef Cuong LM, Nam V, Ha TT, Ha TT, Hung TQ, Van Loi D, Hung TM, Van Son N, Kien VD. Anorectal functional outcomes following Doppler-guided transanal hemorrhoidal dearterialization: evidence from Vietnam. Adv Ther. 2020;37(3):1136–44.CrossRef
14.
go back to reference Lwanga SK, Lemeshow S, Organization WH. Sample size determination in health studies: a practical manual. Geneva: World Health Organization; 1991. Lwanga SK, Lemeshow S, Organization WH. Sample size determination in health studies: a practical manual. Geneva: World Health Organization; 1991.
15.
go back to reference Rao SS, Azpiroz F, Diamant N, Enck P, Tougas G, Wald A. Minimum standards of anorectal manometry. Neurogastroenterol Motil. 2002;14(5):553–9.CrossRef Rao SS, Azpiroz F, Diamant N, Enck P, Tougas G, Wald A. Minimum standards of anorectal manometry. Neurogastroenterol Motil. 2002;14(5):553–9.CrossRef
16.
go back to reference Jorge JM, Habr-Gama A. The value of sphincter asymmetry index in anal incontinence. Int J Colorectal Dis. 2000;15(5–6):303–10.CrossRef Jorge JM, Habr-Gama A. The value of sphincter asymmetry index in anal incontinence. Int J Colorectal Dis. 2000;15(5–6):303–10.CrossRef
17.
go back to reference Vollebregt PF, Rasijeff AM, Pares D, Grossi U, Carrington EV, Knowles CH, Scott SM. Functional anal canal length measurement using high-resolution anorectal manometry to investigate anal sphincter dysfunction in patients with fecal incontinence or constipation. Neurogastroenterol Motility. 2019;31(3):e13532.CrossRef Vollebregt PF, Rasijeff AM, Pares D, Grossi U, Carrington EV, Knowles CH, Scott SM. Functional anal canal length measurement using high-resolution anorectal manometry to investigate anal sphincter dysfunction in patients with fecal incontinence or constipation. Neurogastroenterol Motility. 2019;31(3):e13532.CrossRef
18.
go back to reference Jones MP, Post J, Crowell MD. High-resolution manometry in the evaluation of anorectal disorders: a simultaneous comparison with water-perfused manometry. Am J Gastroenterol. 2007;102(4):850–5.CrossRef Jones MP, Post J, Crowell MD. High-resolution manometry in the evaluation of anorectal disorders: a simultaneous comparison with water-perfused manometry. Am J Gastroenterol. 2007;102(4):850–5.CrossRef
19.
go back to reference Coss-Adame E, Rao SS, Valestin J, Ali-Azamar A, Remes-Troche JM: Accuracy and reproducibility of high-definition anorectal manometry and pressure topography analyses in healthy subjects. Clin Gastroenterol Hepatol. 2015;13(6):1143–50 e1141.CrossRef Coss-Adame E, Rao SS, Valestin J, Ali-Azamar A, Remes-Troche JM: Accuracy and reproducibility of high-definition anorectal manometry and pressure topography analyses in healthy subjects. Clin Gastroenterol Hepatol. 2015;13(6):1143–50 e1141.CrossRef
20.
go back to reference Kritasampan P, Lohsiriwat S, Leelakusolvong S: Manometric tests of anorectal function in healthy adult Thai subjects. J Med Assoc Thai. 2004;87(5):536–42.PubMed Kritasampan P, Lohsiriwat S, Leelakusolvong S: Manometric tests of anorectal function in healthy adult Thai subjects. J Med Assoc Thai. 2004;87(5):536–42.PubMed
21.
go back to reference Lestar B, Penninckx F, Kerremans R: The composition of anal basal pressure. Int J Colorectal Dis. 1989;4(2):118–22.CrossRef Lestar B, Penninckx F, Kerremans R: The composition of anal basal pressure. Int J Colorectal Dis. 1989;4(2):118–22.CrossRef
22.
go back to reference Lestar B, Penninckx F, Rigauts H, Kerremans R: The internal anal sphincter can not close the anal canal completely. Int J Colorectal Disease. 1992;7(3):159–161.CrossRef Lestar B, Penninckx F, Rigauts H, Kerremans R: The internal anal sphincter can not close the anal canal completely. Int J Colorectal Disease. 1992;7(3):159–161.CrossRef
23.
go back to reference Gold D, Bartram C, Halligan S, Humphries K, Kamm M, Kmiot W: Three-dimensional endoanal sonography in assessing anal canal injury. Br J Surg. 1999;86(3):365–70.CrossRef Gold D, Bartram C, Halligan S, Humphries K, Kamm M, Kmiot W: Three-dimensional endoanal sonography in assessing anal canal injury. Br J Surg. 1999;86(3):365–70.CrossRef
24.
go back to reference Williams AB, Cheetham MJ, Bartram CI, Halligan S, Kamm MA, Nicholls RJ, Kmiot WA: Gender differences in the longitudinal pressure profile of the anal canal related to anatomical structure as demonstrated on three-dimensional anal endosonography. Br J Surg. 2000;87(12):1674–9.CrossRef Williams AB, Cheetham MJ, Bartram CI, Halligan S, Kamm MA, Nicholls RJ, Kmiot WA: Gender differences in the longitudinal pressure profile of the anal canal related to anatomical structure as demonstrated on three-dimensional anal endosonography. Br J Surg. 2000;87(12):1674–9.CrossRef
25.
go back to reference Kim J-H: How to interpret conventional anorectal manometry. J Neurogastroenterol Motility 2010;16(4):437–9.CrossRef Kim J-H: How to interpret conventional anorectal manometry. J Neurogastroenterol Motility 2010;16(4):437–9.CrossRef
26.
go back to reference Ratuapli SK, Bharucha AE, Noelting J, Harvey DM, Zinsmeister AR: Phenotypic identification and classification of functional defecatory disorders using high-resolution anorectal manometry. Gastroenterology 2013;144(2):314–22.e312.CrossRef Ratuapli SK, Bharucha AE, Noelting J, Harvey DM, Zinsmeister AR: Phenotypic identification and classification of functional defecatory disorders using high-resolution anorectal manometry. Gastroenterology 2013;144(2):314–22.e312.CrossRef
27.
go back to reference Ratuapli S, Bharucha AE, Harvey D, Zinsmeister AR: Comparison of rectal balloon expulsion test in seated and left lateral positions. Neurogastroenterol Motility: Offi J Eur Gastroint Motility Soc. 2013;25(12):e813-e820.CrossRef Ratuapli S, Bharucha AE, Harvey D, Zinsmeister AR: Comparison of rectal balloon expulsion test in seated and left lateral positions. Neurogastroenterol Motility: Offi J Eur Gastroint Motility Soc. 2013;25(12):e813-e820.CrossRef
28.
go back to reference Seong M-K: Assessment of functional defecation disorders using anorectal manometry. Ann Surg Treat Res. 2018;94(6):330–6.CrossRef Seong M-K: Assessment of functional defecation disorders using anorectal manometry. Ann Surg Treat Res. 2018;94(6):330–6.CrossRef
29.
go back to reference Seo M, Joo S, Jung KW, Lee J, Lee HJ, Soh JS, Yoon IJ, Koo HS, Seo SY, Kim D et al. A high-resolution anorectal manometry parameter based on integrated pressurized volume: a study based on 204 male patients with constipation and 26 controls. Neurogastroenterol Motil. 2018;30(9):e13376.CrossRef Seo M, Joo S, Jung KW, Lee J, Lee HJ, Soh JS, Yoon IJ, Koo HS, Seo SY, Kim D et al. A high-resolution anorectal manometry parameter based on integrated pressurized volume: a study based on 204 male patients with constipation and 26 controls. Neurogastroenterol Motil. 2018;30(9):e13376.CrossRef
30.
go back to reference de Lorijn F, Kremer LC, Reitsma JB, Benninga MA. Diagnostic tests in Hirschsprung disease: a systematic review. J Pediatr Gastroenterol Nutr. 2006;42(5):496–505.CrossRef de Lorijn F, Kremer LC, Reitsma JB, Benninga MA. Diagnostic tests in Hirschsprung disease: a systematic review. J Pediatr Gastroenterol Nutr. 2006;42(5):496–505.CrossRef
31.
go back to reference Cheeney G, Nguyen M, Valestin J, Rao SSC: Topographic and manometric characterization of the recto-anal inhibitory reflex. Neurogastroenterol Motility: Offi J Eur Gastroint Motility Soc. 2012;24(3):e147–e154.CrossRef Cheeney G, Nguyen M, Valestin J, Rao SSC: Topographic and manometric characterization of the recto-anal inhibitory reflex. Neurogastroenterol Motility: Offi J Eur Gastroint Motility Soc. 2012;24(3):e147–e154.CrossRef
32.
go back to reference Carrington EV, Heinrich H, Knowles CH, Fox M, Rao S, Altomare DF, Bharucha AE, Burgell R, Chey WD, Chiarioni G. The international anorectal physiology working group (IAPWG) recommendations: standardized testing protocol and the London classification for disorders of anorectal function. Neurogastroenterol Motility. 2020;32(1):e13679.CrossRef Carrington EV, Heinrich H, Knowles CH, Fox M, Rao S, Altomare DF, Bharucha AE, Burgell R, Chey WD, Chiarioni G. The international anorectal physiology working group (IAPWG) recommendations: standardized testing protocol and the London classification for disorders of anorectal function. Neurogastroenterol Motility. 2020;32(1):e13679.CrossRef
Metadata
Title
Normal values for high-resolution anorectal manometry in healthy young adults: evidence from Vietnam
Authors
Le Manh Cuong
Ha Van Quyet
Tran Manh Hung
Nguyen Ngoc Anh
Tran Thu Ha
Vu Van Du
Do Van Loi
Ha Huu Hoang Khai
Vu Duy Kien
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2021
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-021-01865-8

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