High Resolution and High Definition Anorectal Manometry and Pressure Topography: Diagnostic Advance or a New Kid on the Block?

  • Yeong Yeh Lee
  • Askin Erdogan
  • Satish S. C. RaoEmail author
Neuromuscular Disorders of the Gastrointestinal Tract (S Rao, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Neuromuscular Disorders of the Gastrointestinal Tract


The recent development of closely spaced circumferential solid state transducers has paved the way for novel technology that includes high resolution anorectal manometry and topography (HRAM) and 3-D high definition anorectal manometry (HDAM). These techniques are increasingly being used for the assessment of anorectal neuromuscular function. However, whether they constitute a diagnostic advantage or a mere refinement of an old technology is unknown. Unlike the traditional manometry that utilized 3 or 6 unidirectional sensors, the closely spaced circumferential arrangement facilitates superior spatiotemporal mapping of pressures at rest and during various dynamic maneuvers. HDAM can provide knowledge of the three muscles that govern the anal continence namely, the puborectalis, and the internal and external anal sphincters, and can show how they mediate the rectoanal inhibitory reflex and sensorimotor responses and the spatiotemporal orientation of these muscles. Also, anal sphincter defects can be mapped and readily detected using 3-D technology. Similarly, HRAM has facilitated confirmation and development of phenotypes of dyssynergic defecation. Recently, normative data have also been reported with HRAM and HDAM, together with the influence of age, gender, and test instructions. The greater yield of anatomical and functional information may supersede the limitations of costs, fragility, and shorter life-span associated with these new techniques. Thus, HDAM and HRAM are not just new gadgets but constitute a significant and novel diagnostic advance. However, more prospective studies are needed to better define anorectal disorders with these techniques and to confirm their superiority.


Anorectal manometry High-resolution High-definition Diagnostic 


Compliance with Ethics Guidelines

Conflict of Interest

Yeong Yeh Lee, Askin Erdogan and Satish S. C. Rao declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Yeong Yeh Lee
    • 1
    • 2
  • Askin Erdogan
    • 1
  • Satish S. C. Rao
    • 1
    Email author
  1. 1.Department of Medicine, Section of Gastroenterology & HepatologyGeorgia Regents UniversityAugustaUSA
  2. 2.School of Medical SciencesUniversiti Sains MalaysiaKota BahruMalaysia

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