Under Pressure: Do Volume-Based Measurements Define Rectal Hyposensitivity in Clinical Practice?

Excerpt

Constipation and fecal incontinence are commonly encountered in gastroenterology practices worldwide. Though empiric therapy is recommended as the initial step in care, diagnostic testing to evaluate potential anorectal dysfunction is currently recommended by societal guidelines for cases refractory to lifestyle modification and medical therapy [1, 2]. While several modalities exist by which anorectal function can be evaluated, in practice, anorectal manometry is often the first study employed after the rectal examination—as it is commonly available (at least in comparison with other anorectal tests), less onerous than a barium defecography, and less expensive than a dynamic pelvic MRI. Although other less common testing options include barostat and impedance planimetry, these are offered less frequently than manometry and are usually limited to research centers. …