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Digital Rectal Exams Are Infrequently Performed Prior to Anorectal Manometry

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An Invited Commentary to this article was published on 03 January 2024

Abstract

Background

Digital rectal examination should be performed prior to anorectal manometry; however, real-world data is lacking.

Aims

Characterize real world rates of digital rectal and their sensitivity for detecting dyssynergia compared to anorectal manometry and balloon expulsion test.

Methods

A retrospective single-center study was conducted to examine all patients who underwent anorectal manometry for chronic constipation between 2021 and 2022 at one tertiary center with motility expertise. Primary outcomes consisted of the rate of digital rectal exam prior to anorectal manometry; and secondary outcomes included the sensitivity of digital rectal exam for dyssynergic defecation.

Results

Only 42.3% of 142 patients had digital rectal examinations prior to anorectal manometry. Overall sensitivity for detecting dyssynergic defecation was 46.4%, but significantly higher for gastroenterology providers (p = .004), and highest for gastroenterology attendings (82.6%).

Conclusions

Digital rectal examination is infrequently performed when indicated for chronic constipation. Sensitivity for detecting dyssynergic defecation may be impacted by discipline and level of training.

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Authors and Affiliations

  1. Icahn School of Medicine at Mount Sinai, Mount Sinai Morningside and West Hospitals, New York, NY, 10019, USA

    Joseph A. Menand, Robinderpal Sandhu & Ahmun Zafar

  2. Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA

    Yonatan Israel & Emma Reford

  3. Icahn School of Medicine at Mount Sinai, Mount Sinai Center for GI Physiology and Motility, New York, NY, 10019, USA

    Priyanka Singh, Kimberly Cavaliere, Jean Saleh, Michael S. Smith, Daniela Jodorkovsky & Yuying Luo

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  1. Joseph A. Menand
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  2. Robinderpal Sandhu
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  4. Emma Reford
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Contributions

JAM: conception, data collection, statistical planning and analysis, original draft, provided final draft approval. RS: data collection, statistical analysis, original draft, provided final draft approval. YI, ER and AZ: data collection, draft editing, provided final draft approval. PS, KC, JS, MSS and DJ: conception, draft editing, provided final draft approval. YL: conception, statistical planning and analysis, original draft, provided final draft approval.

Corresponding author

Correspondence to Joseph A. Menand.

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An invited commentary on this article is available at https://doi.org/10.1007/10.1007/s10620-023-08234-3

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Menand, J.A., Sandhu, R., Israel, Y. et al. Digital Rectal Exams Are Infrequently Performed Prior to Anorectal Manometry. Dig Dis Sci 69, 728–731 (2024). https://doi.org/10.1007/s10620-023-08243-2

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  • DOI: https://doi.org/10.1007/s10620-023-08243-2

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