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High-Resolution Anorectal Manometry and 3D High-Definition Anorectal Manometry in Pediatric Settings

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High Resolution and High Definition Anorectal Manometry
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Abstract

Anorectal manometry (ARM) represents the most commonly performed motility test in pediatric populations. It is a valuable tool to assess anorectal muscle function and coordination, the presence of recto-anal inhibitory reflex, the sphincter tonic contractions and relaxations upon different provocative maneuvers, and the thresholds for rectal and anal sensations. In children, although chronic refractory constipation represents the most important indication for ARM, the latter is also useful for the evaluation of fecal incontinence.

The recent advent of novel technology advances, e.g., high-resolution (HRAM) and 3D high-definition (3DHDAM), has led to increased diagnostic accuracy, making ARM easier to perform and interpret. Nevertheless, the absence of universally agreed normal values in pediatric populations still represents one of the major limitations.

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References

  1. Fritsch H, Brenner E, Lienemann A, Ludwikowski B. Anal sphincter complex: reinterpreted morphology and its clinical relevance. Dis Colon Rectum. 2002;45(2):188–94.

    Article  Google Scholar 

  2. Kumar S, Ramadan S, Gupta V, Helmy S, Atta I, Alkholy A. Manometric tests of anorectal function in 90 healthy children: a clinical study from Kuwait. J Pediatr Surg. 2009;44(9):1786–90.

    Article  Google Scholar 

  3. Benninga MA, Wijers OB, van der Hoeven CW, Taminiau JA, Klopper PJ, Tytgat GN, et al. Manometry, profilometry, and endosonography: normal physiology and anatomy of the anal canal in healthy children. J Pediatr Gastroenterol Nutr. 1994;18(1):68–77.

    Article  CAS  Google Scholar 

  4. Bajwa A, Emmanuel A. The physiology of continence and evacuation. Best Pract Res Clin Gastroenterol. 2009;23(4):477–85.

    Article  Google Scholar 

  5. Rasijeff AMP, Withers M, Burke JM, Jackson W, Scott SM. High-resolution anorectal manometry: a comparison of solid-state and water-perfused catheters. Neurogastroenterol Motil. 2017;29(11):13124. https://doi.org/10.1111/nmo.13124.

    Article  Google Scholar 

  6. Lee TH, Bharucha AE. How to perform and interpret a high-resolution anorectal manometry test. J Neurogastroenterol Motil. 2016;22(1):46–59.

    Article  Google Scholar 

  7. Ambartsumyan L, Rodriguez L, Morera C, Nurko S. Longitudinal and radial characteristics of intra-anal pressures in children using 3D high-definition anorectal manometry: new observations. Am J Gastroenterol. 2013;108(12):1918–28.

    Article  Google Scholar 

  8. Banasiuk M, Banaszkiewicz A, Dziekiewicz M, Załęski A, Albrecht P. Values from three-dimensional high-resolution anorectal manometry analysis of children without lower gastrointestinal symptoms. Clin Gastroenterol Hepatol. 2016;14(7):993–1000.e3.

    Article  Google Scholar 

  9. Di Lorenzo C, Hillemeier C, Hyman P, Loening-Baucke V, Nurko S, Rosenberg A, et al. Manometry studies in children: minimum standards for procedures. Neurogastroenterol Motil. 2002;14(4):411–20.

    Article  Google Scholar 

  10. Rodriguez L, Sood M, Di Lorenzo C, Saps M. An ANMS-NASPGHAN consensus document on anorectal and colonic manometry in children. Neurogastroenterol Motil. 2017;29(1):12944. https://doi.org/10.1111/nmo.12944.

    Article  Google Scholar 

  11. Tran K, Kuo B, Zibaitis A, Bhattacharya S, Cote C, Belkind-Gerson J. Effect of propofol on anal sphincter pressure during anorectal manometry. J Pediatr Gastroenterol Nutr. 2014;58(4):495–7.

    Article  CAS  Google Scholar 

  12. Keshtgar AS, Choudhry MS, Kufeji D, Ward HC, Clayden GS. Anorectal manometry with and without ketamine for evaluation of defecation disorders in children. J Pediatr Surg. 2015;50(3):438–43.

    Article  CAS  Google Scholar 

  13. Pfefferkorn MD, Croffie JM, Corkins MR, Gupta SK, Fitzgerald JF. Impact of sedation and anesthesia on the rectoanal inhibitory reflex in children. J Pediatr Gastroenterol Nutr. 2004;38(3):324–7.

    Article  Google Scholar 

  14. Lamparyk K, Mahajan L, Debeljak A, Steffen R. Anxiety associated with high-resolution anorectal manometry in pediatric patients and parents. J Pediatr Gastroenterol Nutr. 2017;65(5):e98–e100.

    Article  Google Scholar 

  15. Fortier MA, Kain ZN. Treating perioperative anxiety and pain in children: a tailored and innovative approach. Paediatr Anaesth. 2015;25(1):27–35.

    Article  Google Scholar 

  16. Dias R, Baliarsing L, Barnwal NK, Mogal S, Gujjar P. Role of pre-operative multimedia video information in allaying anxiety related to spinal anaesthesia: a randomised controlled trial. Indian J Anaesth. 2016;60(11):843–7.

    Article  Google Scholar 

  17. Lewis Claar R, Walker LS, Barnard JA. Children’s knowledge, anticipatory anxiety, procedural distress, and recall of esophagogastroduodenoscopy. J Pediatr Gastroenterol Nutr. 2002;34(1):68–72.

    Article  Google Scholar 

  18. Zar-Kessler C, Belkind-Gerson J. Anorectal manometry. In: NT CF, Di Lorenzo C, editors. Pediatric neurogastroenterology. Cham: Springer; 2017. p. 117–28.

    Chapter  Google Scholar 

  19. Belkind-Gerson J, Goldstein AM, Kuo B. Balloon expulsion test as a screen for outlet obstruction in children with chronic constipation. J Pediatr Gastroenterol Nutr. 2013;56(1):23–6.

    Article  Google Scholar 

  20. Carrington EV, Brokjaer A, Craven H, Zarate N, Horrocks EJ, Palit S, 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.

    Article  CAS  Google Scholar 

  21. 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.

    Article  Google Scholar 

  22. 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 Color Dis. 2013;28(8):1161–8.

    Article  Google Scholar 

  23. 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.e1.

    Article  Google Scholar 

  24. Vitton V, Ben Hadj Amor W, Baumstarck K, Grimaud JC, Bouvier M. Water-perfused manometry vs three-dimensional high-resolution manometry: a comparative study on a large patient population with anorectal disorders. Color Dis. 2013;15(12):e726–31.

    Article  CAS  Google Scholar 

  25. Carrington EV, Grossi U, Knowles CH, Scott SM. Normal values for high-resolution anorectal manometry: a time for consensus and collaboration. Neurogastroenterol Motil. 2014;26(9):1356–7.

    Article  CAS  Google Scholar 

  26. Lee HJ, Jung KW, Han S, Kim JW, Park SK, Yoon IJ, 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.

    Article  CAS  Google Scholar 

  27. Tang YF, Chen JG, An HJ, Jin P, Yang L, Dai ZF, et al. High-resolution anorectal manometry in newborns: normative values and diagnostic utility in Hirschsprung disease. Neurogastroenterol Motil. 2014;26(11):1565–72.

    Article  Google Scholar 

  28. Benninga MA, Omari TI, Haslam RR, Barnett CP, Dent J, Davidson GP. Characterization of anorectal pressure and the anorectal inhibitory reflex in healthy preterm and term infants. J Pediatr. 2001;139(2):233–7.

    Article  CAS  Google Scholar 

  29. de Lorijn F, Omari TI, Kok JH, Taminiau JA, Benninga MA. Maturation of the rectoanal inhibitory reflex in very premature infants. J Pediatr. 2003;143(5):630–3.

    Article  Google Scholar 

  30. Li ZH, Dong M, Wang ZF. Functional constipation in children: investigation and management of anorectal motility. World J Pediatr. 2008;4(1):45–8.

    Article  Google Scholar 

  31. Sutphen J, Borowitz S, Ling W, Cox DJ, Kovatchev B. Anorectal manometric examination in encopretic-constipated children. Dis Colon Rectum. 1997;40(9):1051–5.

    Article  CAS  Google Scholar 

  32. Wu JF, Lu CH, Yang CH, Tsai IJ. Diagnostic role of anal sphincter relaxation integral in high-resolution anorectal manometry for Hirschsprung disease in infants. J Pediatr. 2018;194:136–41.e2.

    Article  Google Scholar 

  33. Langer JC, Rollins MD, Levitt M, Gosain A, Torre L, Kapur RP, et al. Guidelines for the management of postoperative obstructive symptoms in children with Hirschsprung disease. Pediatr Surg Int. 2017;33(5):523–6.

    Article  CAS  Google Scholar 

  34. Siddiqui A, Rosen R, Nurko S. Anorectal manometry may identify children with spinal cord lesions. J Pediatr Gastroenterol Nutr. 2011;53(5):507–11.

    PubMed  Google Scholar 

  35. Huang YH. Neurogenic bowel: dysfunction and rehabilitation. In: Cifu DX, Lew HL, editors. Braddom’s clinical handbook of physical medicine and rehabilitation. Amsterdam: Elsevier; 2018. p. 143–149.e7.

    Chapter  Google Scholar 

  36. 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.e2.

    Article  Google Scholar 

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Di Chio, T., Pesce, M., Peroni, D., Borrelli, O. (2020). High-Resolution Anorectal Manometry and 3D High-Definition Anorectal Manometry in Pediatric Settings. In: Bellini, M. (eds) High Resolution and High Definition Anorectal Manometry. Springer, Cham. https://doi.org/10.1007/978-3-030-32419-3_8

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  • DOI: https://doi.org/10.1007/978-3-030-32419-3_8

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