Anorectal manometry

Anorectal manometry
Diagram of the anorectum. This is the location where the probe is inserted and where pressures are measured.
OPS-301 code1-315

Anorectal manometry (ARM) is a medical test used to measure pressures in the anus and rectum and to assess their function.[1][2] The test is performed by inserting a catheter, that contains a probe embedded with pressure sensors, through the anus and into the rectum.[3] Patients may be asked to perform certain maneuvers, such as coughing or attempting to defecate, to assess for pressure changes.[3] Anorectal manometry is a safe[4] and low risk[3] procedure.

From 2014 to 2018, the international anorectal physiology working group (IAPWG) meet several times to develop consensus on indications for anorectal manometry.[5] Their assessment concluded that anorectal manometry was indicated when used in assessment of fecal incontinence, constipation, evacuation disorders (including Hirschsprung's disease[6]), functional anorectal pain and in the assessment of anorectal function preoperatively or after a traumatic obstetric injury.[5] In addition to the indications outlined by the IAPWG, anorectal manometry has been used as a component of anorectal biofeedback.[6]

Since its introduction in 2007, high resolution anorectal manometry (HR-ARM) has increasingly replaced conventional anorectal manometry as the standard.[7] There has been increasing usage of high-definition (3D) anorectal manometry (HD-ARM) as well.[7] Current advances in anorectal manometry include the development of bedside portable technology.[7]

  1. ^ Cash BD (15 September 2008). Curbside Consultation of the Colon: 49 Clinical Questions. SLACK Incorporated. pp. 67–. ISBN 978-1-55642-831-9. Retrieved 10 November 2010.
  2. ^ Craft TM, Parr MJ, Nolan JP (2004-11-10). Key Topics in Critical Care, Second Edition. CRC Press. p. 1011. ISBN 9781841843582.
  3. ^ a b c Lee TH, Bharucha AE (January 2016). "How to Perform and Interpret a High-resolution Anorectal Manometry Test". Journal of Neurogastroenterology and Motility. 22 (1): 46–59. doi:10.5056/jnm15168. PMC 4699721. PMID 26717931.
  4. ^ Heinrich H, Misselwitz B (April 2018). "High-Resolution Anorectal Manometry - New Insights in the Diagnostic Assessment of Functional Anorectal Disorders". Visceral Medicine. 34 (2): 134–139. doi:10.1159/000488611. PMC 5981680. PMID 29888243.
  5. ^ a b Carrington EV, Heinrich H, Knowles CH, Fox M, Rao S, Altomare DF, et al. (January 2020). "The international anorectal physiology working group (IAPWG) recommendations: Standardized testing protocol and the London classification for disorders of anorectal function". Neurogastroenterology and Motility. 32 (1): e13679. doi:10.1111/nmo.13679. PMC 6923590. PMID 31407463.
  6. ^ a b Basilisco G, Bharucha AE (August 2017). "High-resolution anorectal manometry: An expensive hobby or worth every penny?". Neurogastroenterology and Motility. 29 (8): e13125. doi:10.1111/nmo.13125. PMC 5609826. PMID 28699318.
  7. ^ a b c Scott SM, Carrington EV (September 2020). "The London Classification: Improving Characterization and Classification of Anorectal Function with Anorectal Manometry". Current Gastroenterology Reports. 22 (11): 55. doi:10.1007/s11894-020-00793-z. PMC 7497505. PMID 32935278.
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