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Performing, Analyzing, and Interpreting HRAM and HDAM Recordings

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High Resolution and High Definition Anorectal Manometry

Abstract

Anorectal manometry is one of the most widely performed tests for the assessment of anal sphincter function and anorectal coordination. Nowadays high resolution (HRAM) and high definition anorectal manometry (HDAM) are available, instead of the water-perfused system. The ability to visualize the anorectum as a dynamic structure during test maneuvers should intuitively allow for a better appreciation of the normal physiology and hopefully enhance our understanding of the pathophysiology of defecatory dysfunctions. Even if the anorectal manometry protocols can vary by centers, the procedure must include an assessment of rectoanal pressure and anal canal length at rest, cough reflex test, rectoanal pressures during squeeze, simulated evacuation, and rectal sensation. Although it is becoming an increasingly widespread examination, at present the normality values for different examined parameters, shared between different centers, are not available, and it would therefore be desirable to define the parameters of normality shared at the Italian and European level.

HRAM and HDAM as well as conventional manometry can diagnose different functional anorectal disorders, such as fecal incontinence, inadequate defecatory propulsion, and dyssynergic defecation. In addition this new system can help in the diagnosis of some anatomical disorders such as rectal intussusception and rectal prolapse, rectocele, descending perineum syndrome. HRAM is also necessary for the diagnosis of Hirschsprung’s disease.

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Change history

  • 11 April 2020

    The chapter “Performing, Analyzing, and Interpreting HRAM and HDAM Recordings” was inadvertently published without the reference and its citation within the text. The corrected version is available on doi: https://doi.org/10.1007/978-3-030-32419-3_11 with reference number “<reference number>”.

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Author information

Authors and Affiliations

  1. Physiopatology and Manometry Section, Gastroenterology Unit, Cardinal Massaia Hospital, Asti, Italy

    Edda Battaglia

  2. Unit of Gastroenterology and Digestive Endoscopy, San Giovanni - Addolorata Hospital, Rome, Italy

    Lucia D’Alba

  3. Department of General and Emergency Surgery, University of Palermo, Palermo, Italy

    Antonella La Brocca

  4. Department of Medical and Surgical Sciences, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy

    Francesco Torresan

Authors
  1. Edda Battaglia
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  2. Lucia D’Alba
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  3. Antonella La Brocca
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  4. Francesco Torresan
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Editors and Affiliations

  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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Battaglia, E., D’Alba, L., La Brocca, A., Torresan, F. (2020). Performing, Analyzing, and Interpreting HRAM and HDAM Recordings. In: Bellini, M. (eds) High Resolution and High Definition Anorectal Manometry. Springer, Cham. https://doi.org/10.1007/978-3-030-32419-3_7

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  • DOI: https://doi.org/10.1007/978-3-030-32419-3_7

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-32418-6

  • Online ISBN: 978-3-030-32419-3

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