Anorectal physiology in health: A randomized trial to determine the optimum catheter for the balloon expulsion test

2019 ◽  
Vol 31 (4) ◽  
pp. e13552 ◽  
Author(s):  
Yoav Mazor ◽  
Gillian Prott ◽  
Mike Jones ◽  
John Kellow ◽  
Anastasia Ejova ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Anorectal Physiology ◽  
Balloon Expulsion ◽  
Balloon Expulsion Test

scholarly journals Recommendations for the Protocol of functional examination of the anorectal zone and disorders classification: the International Anorectal Physiology Working Group consensus and Russian real-world practice

2020 ◽  
Vol 92 (12) ◽  
pp. 105-119
Author(s):  
O. Yu. Fomenko ◽  
S. V. Morozov ◽  
S. Mark Scott ◽  
H. Charles Knowles ◽  
D. A. Morozov ◽  
...  
Keyword(s):  
Real World ◽  
Working Group ◽  
Anorectal Function ◽  
Anorectal Physiology ◽  
Rectal Sensation ◽  
High Resolution Manometry ◽  
Additional Information ◽  
Wide Range ◽  
Balloon Expulsion ◽  
Function Testing

This manuscript summarizes consensus reached by the International Anorectal Physiology Working Group (IAPWG) for the performance, terminology used, and interpretation of anorectal function testing including anorectal manometry (focused on high-resolution manometry), the rectal sensory test, and the balloon expulsion test. Based on these measurements, a classification system for disorders of anorectal function is proposed. Aim to provide information about methods of diagnosis and new classification of functional anorectal disorders to a wide range of specialists general practitioners, therapists, gastroenterologists, coloproctologists all who face the manifestations of these diseases in everyday practice and determine the diagnostic and therapeutic algorithm. Current paper provides agreed statements of IAPWG Consensus and comments (in italics) of Russian experts on real-world practice, mainly on methodology of examination. These comments in no way intended to detract from the provisions agreed by the international group of experts. We hope that these comments will help to improve the quality of examination based on the systematization of local experience with the use of the methods discussed and the results obtained. Key recommendations: the International Anorectal Physiology Working Group protocol for the performance of anorectal function testing recommends a standardized sequence of maneuvers to test rectoanal reflexes, anal tone and contractility, rectoanal coordination, and rectal sensation. Major findings not seen in healthy controls defined by the classification are as follows: rectoanal areflexia, anal hypotension and hypocontractility, rectal hyposensitivity, and hypersensitivity. Minor and inconclusive findings that can be present in health and require additional information prior to diagnosis include anal hypertension and dyssynergia.

scholarly journals Ameliorating Effects of Transcutaneous Electrical Acustimulation at Neiguan (PC6) and Zusanli (ST36) Acupoints Combined with Adaptive Biofeedback Training on Functional Outlet Obstruction Constipation

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Jie Liu ◽  
Hulin Chen ◽  
Dewei Wu ◽  
Ruiling Wei ◽  
Chaolan Lv ◽  
...  
Keyword(s):  
Frequency Band ◽  
Outlet Obstruction ◽  
Low Frequency ◽  
Biofeedback Training ◽  
Before And After ◽  
Balloon Expulsion ◽  
Group A ◽  
Functional Outlet Obstruction ◽  
Group B ◽  
Balloon Expulsion Test

Background. Stimulant laxatives are still considered the most common treatment for functional outlet obstruction constipation (FOOC). However, the effectiveness of laxatives is unsatisfactory, and the long-term use of laxatives may cause certain adverse events. With this in mind, it is, however, paramount that novel complementary treatment(s) and/or other forms of alternative medicine are adequately investigated. Aims. The study aims to explore the effects and potential mechanism(s) of transcutaneous electrical acustimulation (TEA) combined with adaptive biofeedback training (ABT) on FOOC. Methods. A total of forty-five patients with FOOC were recruited and were randomly assigned to receive either Macrogol 4000 Powder (MAC, 10 g bid) (group A, n = 15) only, ABT + MAC + Sham-TEA (group B, n = 15), or TEA + ABT + MAC (group C, n = 15) in a six-week study. Individual patients' constipation-symptoms (PAC-SYM) and constipation-quality of life (PAC-QOL) were both assessed and scored. Serum acetylcholine (Ach) and nitric oxide (NO) were measured from drawn blood samples while individual patients' heart rate variability (HRV) was calculated at baseline and after each corresponding therapy. Anorectal manometry and balloon expulsion test were both performed before and after treatment. Results. Firstly, participants in group C had significantly lower scores of PAC-SYM, PAC-QOL, and a decreased anal defecating pressure (ADP) as compared to participants in group B (all p<0.050). These results, however, suggest the TEAs effect. Secondly, the low-frequency band (LF)/(LF + HF) ratio in groups B and C were decreased as compared to group A (p=0.037, p=0.010, respectively) regarding HRV. On the other hand, the high-frequency band (HF)/(LF + HF) ratio in groups B and C showed an opposite outcome. Finally, the serum Ach in groups B and C was significantly higher as compared to group A (p=0.023, p=0.012, respectively). Of significant importance, the serum NO in groups B and C were notably low as compared to group A (p=0.001, p<0.001, respectively). Conclusions. TEA, combined with ABT, effectively improves constipation symptoms as well as QOL in FOOC patients. It is, however, achieved by decreasing ADP, which mechanisms are mediated via the autonomic and enteric mechanisms.

98 HOW OFTEN DOES “SQUATTTY POTTY” CORRECT AN ABNORMAL BALLOON EXPULSION TEST IN CHRONICALLY CONSTIPATED PATIENTS?

2021 ◽  
Vol 160 (6) ◽  
pp. S-21-S-22
Author(s):  
Eden Koo ◽  
Gabrielle Ezell ◽  
William D. Chey ◽  
Jason Baker ◽  
Moira Armstrong ◽  
...  
Keyword(s):  
Balloon Expulsion ◽  
Balloon Expulsion Test

Su1622 - Phenotypic Identification of Large Rectoceles using Anal Surface Electromyography, Balloon Expulsion Test, and Barium Defecography

2018 ◽  
Vol 154 (6) ◽  
pp. S-551-S-552
Author(s):  
Tae Hee Lee ◽  
Adil E. Bharucha ◽  
Joon Seong Lee ◽  
Su Jin Hong ◽  
Young Sin Cho ◽  
...  
Keyword(s):  
Surface Electromyography ◽  
Phenotypic Identification ◽  
Balloon Expulsion ◽  
Balloon Expulsion Test

scholarly journals Sacral magnetic stimulation in puborectalis paradoxical syndrome

2002 ◽  
Vol 49 (2) ◽  
pp. 27-32 ◽  
Author(s):  
A. Shafik
Keyword(s):  
Magnetic Stimulation ◽  
Pressure Rise ◽  
Canine Model ◽  
Outpatient Basis ◽  
Rectal Balloon ◽  
Balloon Expulsion ◽  
Rectal Pressure ◽  
Balloon Expulsion Test ◽  
Neck Pressure ◽  
Rectal Neck

Background and Purpose: Our earlier studies have demonstrated that sacral magnetic stimulation (IMS) in the canine model, in healthy volunteers and in constipated subjects effected rectal pressure rise, decline of the rectal neck (anal canal) pressure as well as rectal evacuation. Based on these results, we studied the effect of sacral MS on defecation in patients with puborectalis paradoxical syndrome (PPS). Methods: Eleven subjects (8 women, 3 men; age 36-53 years) with PPS were enrolled in the study. The magnetic coil was placed on the back with its center located between L4 and L5. Stimulation parameters were set at 70% of maximum intensity, 40 Hz frequency and 2-second burst length with 2 seconds off. During MS, the rectal neck and gastric (intra-abdominal) pressures were measured. The procedure was performed in the empty and in the full rectum using the balloon expulsion test in the latter. Results: MS of the empty and balloon-filled rectum effected rise of the rectal pressure (p<0.001), decline of the rectal neck pressure (p>0.001) and no significant change of the intragastric pressure (p>0.05). The balloon was expelled to the exterior in all the patients. Conclusions: Sacral MS succeeded in dispelling to the exterior the water-filled rectal balloon. The method is simple, easy, non-invasive, non-radiologic and can be performed on an outpatient basis for the treatment of PPS.

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