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Differences Between Conventional Anorectal Manometry and High Resolution/High Definition Anorectal Manometry

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High Resolution and High Definition Anorectal Manometry

Abstract

From the pioneering experiments of Denny-Brown and Robertson in 1935 to the later introduction of electronics, anorectal manometry is one of the most important diagnostic methods for the study of the anorectal disease. While at the beginning it was mainly used for the diagnosis of Hirschsprung disease, later anorectal manometry proved to be the most appropriate tool for the study of anorectal motility, employed in a wide range of rectoanal problems, including constipation and fecal incontinence.

Conventional anorectal manometry (ARM) is widely available, easy to perform, and well accepted by patients. However, interpretation of its findings can be difficult owing to the wide variability of manometric measurements both in health and disease. High-resolution anorectal manometry (HRAM) systems, acquiring measurements from at least ten closely spaced pressure sensors across the anal sphincter, provide visual feedback to the operator and remove the need for the pull-through procedure, facilitating the maintenance of a stable catheter position. Both HRAM and High Definition Anorectal Manometry (HDAM) catheters provide a better assessment of the sphincter pressure profile than conventional catheters.

HRAM and HDAM allowed to develop new parameters, which could be used in differentiating patients from healthy subjects, such as the anal contractile integral (ACI), the post contraction pressure (PSP), the integrated pressure of the anal relaxation (aIRP), and the sliding speed of the probe during the squeeze in the anal canal (SVAC).

Although these new proposed measurements seem promising, and probably could be useful to achieve a clearer knowledge of anorectal function, further studies, with a larger number of subjects, are needed to validate their reliability.

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Authors and Affiliations

  1. Department of Medical and Surgical Sciences, Policlinico Sant’Orsola Malpighi, Bologna, Italy

    Francesco Torresan & Daniele Mandolesi

  2. Department of Surgical, Oncological and Oral Science, University of Palermo, Policlinico P. Giaccone, Palermo, Italy

    Sebastiano Bonventre

  3. Gastroenterology Unit, G. Brotzu Hospital, Cagliari, Italy

    Paolo Usai-Satta

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  1. Francesco Torresan
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  2. Daniele Mandolesi
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  3. Sebastiano Bonventre
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  4. Paolo Usai-Satta
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Correspondence to Francesco Torresan .

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  1. Gastrointestinal Unit, Department of Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy

    Massimo Bellini

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Torresan, F., Mandolesi, D., Bonventre, S., Usai-Satta, P. (2020). Differences Between Conventional Anorectal Manometry and High Resolution/High Definition Anorectal Manometry. In: Bellini, M. (eds) High Resolution and High Definition Anorectal Manometry. Springer, Cham. https://doi.org/10.1007/978-3-030-32419-3_5

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  • DOI: https://doi.org/10.1007/978-3-030-32419-3_5

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