The effect of standard compared to enhanced instruction and verbal feedback on anorectal manometry measurements

• DOI: 10.1111/nmo.12038
• Publication Date: 2012-11-07T02:46:29Z
• Authors: H. Heinrich; H. Fruehauf; M. Sauter; A. Steingötter; M. Fried; W. Schwizer; M. Fox
• Keywords: Anorectal manometry; High resolution manometry; Biofeedback; Fecal Incontinence; Obstructed defecation

Abstract Background Guidelines recommend instruction and motivation during anorectal manometry; however, its impact on findings has not been reported. This study assessed the effects of standard versus enhanced verbal feedback results manometry. Methods High‐resolution manometry was performed by a solid‐state catheter with 10 circumferential sensors at 6 mm separation across anal canal two rectal sensors. Measurements were acquired first then feedback. On both occasions, squeeze pressure duration three voluntary contractions intra‐rectal recto‐anal gradient (RAPG) attempts simulated defecation assessed. Key Results A total 70 consecutive patients (54 female; age 25–82 years) referred for investigation fecal incontinence ( n = 31), constipation, related disorders 39) studied. Enhanced increased maximum (Δ10 ± 28.5 mmHg; P < 0.0038) contraction (Δ3 4 s; 0.0001). During defecation, it (Δ12 14 0.003) RAPG (Δ11 20 Using diagnostic criteria, intervention changed manometric from locally validated ‘pathologic’ to ‘normal’ values in 14/31 12/39 defecation. Conclusions & Inferences significantly improved functions resulted clinically relevant change diagnosis some patients. Effective explanation procedures is required ensure consistent provide an accurate representation patient ability retain continence evacuate stool.