Article
Medicine, General & Internal
Justin Y. van Oostendorp, Pieter van Hagen, Grietje J. H. van der Mijnsbrugge, Ingrid J. M. Han-Geurts
Summary: Anorectal manometry measurements show significant interrater variability. New techniques like 3D high-resolution anorectal manometry (3D-HRAM) have the potential to improve diagnostic accuracy and understanding of defecation disorders. However, the extent of interrater variability in 3D-HRAM is still unknown.
Review
Gastroenterology & Hepatology
Satish S. C. Rao, Nitin K. Ahuja, Adil E. Bharucha, Darren M. Brenner, William D. Chey, Jill K. Deutsch, David C. Kunkel, Baharak Moshiree, Leila Neshatian, Robert M. Reveille, Gregory S. Sayuk, Jordan M. Shapiro, Eric D. Shah, Kyle Staller, Steven D. Wexner, Jason R. Baker
Summary: This article discusses the application and challenges of anorectal manometry (ARM) in the diagnosis and treatment of anorectal disorders. ARM can identify key pathophysiological abnormalities and is a critical component of biofeedback therapy. However, barriers to its utilization include a lack of education and training, challenges with testing protocols and interpretation, and confusion over billing practices.
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
(2023)
Review
Surgery
C. Desprez, V. Bridoux, A. -M. Leroi
Summary: Functional defecation disorders and fecal incontinence are common anorectal disorders that present with overlapping symptoms and pose management dilemmas. Advanced diagnostic methods can accurately define the underlying abnormalities.
JOURNAL OF VISCERAL SURGERY
(2022)
Review
Pediatrics
Ilan J. N. Koppen, Marc A. Benninga
Summary: Defecation is a complex physiological process relying on intricate mechanisms involving the autonomic and somatic nervous system, pelvic floor muscles, and anal sphincter complex. Anorectal dysfunction can lead to constipation, a bothersome disorder that significantly impacts the daily lives of children and their families. This review focuses on different mechanisms underlying anorectal dysfunction and specific treatment options for improving defecation dynamics in children with functional constipation.
FRONTIERS IN PEDIATRICS
(2022)
Article
Gastroenterology & Hepatology
Mayank Sharma, Ann C. Lowry, Satish S. Rao, William E. Whitehead, Lawrence A. Szarka, Frank A. Hamilton, Adil E. Bharucha
Summary: The study aimed to generate reference values for anorectal pressures, examining the effects of gender and age. Results showed that anal and rectal pressures measured using diagnostic and biofeedback catheters were correlated and not significantly different, with pressures found to be influenced by age and sex. Specific pressures during different activities varied among different gender and age groups, providing valuable reference values for clinicians.
NEUROGASTROENTEROLOGY AND MOTILITY
(2021)
Article
Medicine, General & Internal
Samuel Tanner, Ahson Chaudhry, Navneet Goraya, Rohan Badlani, Asad Jehangir, Dariush Shahsavari, Zubair Malik, Henry P. Parkman
Summary: In patients with chronic constipation, about 22% have dyssynergic defecation (DD), about 55% have slow transit constipation (STC), and 13% have both DD and STC. There were no specific symptoms differentiating STC from DD, but patients with STC and DD reported more severe constipation symptoms.
JOURNAL OF CLINICAL MEDICINE
(2021)
Review
Gastroenterology & Hepatology
Anahita Sadeghi, Elham Akbarpour, Fatemeh Majidirad, Serhat Bor, Mojgan Forootan, Mohammad-Reza Hadian, Peyman Adibi
Summary: About one-third of chronically constipated patients suffer from an evacuation disorder known as dyssynergic defecation, where the coordination between abdominal and pelvic floor muscles is disrupted. The etiology of this condition is still unknown, but diagnostic methods such as anorectal manometry, balloon expulsion test, and imaging techniques like magnetic resonance or conventional defecography are necessary. Biofeedback therapy is considered as one of the most effective and safe treatments for dyssynergic defecation. This article provides an overview of the condition and its diagnosis and management.
TURKISH JOURNAL OF GASTROENTEROLOGY
(2023)
Article
Gastroenterology & Hepatology
Yuemei Xu, Xiaoping Li, Feizhen Xia, Feng Xu, Jiande D. Z. Chen
Summary: The modified adaptive biofeedback (ABF) training significantly improves constipation-related symptoms and is superior to conventional fixed biofeedback (FBF) training for dyssynergic defecation.
DIGESTIVE DISEASES AND SCIENCES
(2022)
Review
Gastroenterology & Hepatology
Alexandra R. Ortengren, Resham A. Ramkissoon, William D. Chey, Jason R. Baker, Kyle Staller, Johanna Iturrino, Eric D. Shah
Summary: A systematic review and meta-analysis showed that anorectal manometry has good diagnostic accuracy for detecting dyssynergic defecation, especially when three consecutive simulated defecation attempts are performed. However, measuring anorectal pressures to identify complex dyssynergic patterns did not improve real-world diagnostic accuracy estimates. Future iterations of the consensus protocol may improve diagnostic accuracy.
NEUROGASTROENTEROLOGY AND MOTILITY
(2021)
Article
Gastroenterology & Hepatology
Elie Abi Nader, Ombeline Roche, Jean-Philippe Jais, Julie Salomon, Olivier Goulet, Florence Campeotto
Summary: This study examined the efficacy of biofeedback therapy in children with fecal incontinence caused by chronic constipation, showing that biofeedback can be an effective tool for managing this condition in resistant cases.
CLINICS AND RESEARCH IN HEPATOLOGY AND GASTROENTEROLOGY
(2021)
Article
Gastroenterology & Hepatology
Yun Yan, Amol Sharma, Anam A. Herekar, Enoe Jimenez, Amit R. Hudgi, Qiaochu G. Gu, Satish S. C. Rao
Summary: This observational cohort study developed a novel test for diagnosing fecal incontinence. By stimulating nerve plexuses and recording muscle motor potentials, the study found that lumbar or sacral plexus neuropathy was detected in 40% to 75% of patients with fecal incontinence, with a 2-fold greater prevalence at the anal region than the rectum.
DISEASES OF THE COLON & RECTUM
(2022)
Article
Gastroenterology & Hepatology
Sanne J. Verkuijl, Monika Trzpis, Paul M. A. Broens
Summary: This study found that there may be a neural pathway in the anal canal that leads to rectal contraction to assist defaecation. Anal anaesthesia significantly decreased rectal contraction and the electrosensitivity of the anal canal was negatively correlated with maximum rectal contraction.
COLORECTAL DISEASE
(2022)
Article
Gastroenterology & Hepatology
M. S. Gh. Alketbi, J. Meyer, J. Robert-Yap, R. Scarpa, E. Gialamas, Z. Abbassi, A. Balaphas, N. Buchs, B. Roche, F. Ris
Summary: Puborectalis muscle rupture often results from peri-partum perineal trauma and may lead to various pelvic organ prolapses. This study aimed to evaluate the management and treatment of functional disorders associated with such ruptures, showing that surgical repair significantly improved puborectalis muscle function and sexual function in patients.
TECHNIQUES IN COLOPROCTOLOGY
(2021)
Article
Gastroenterology & Hepatology
Nayna A. Lodhia, Laura Horton, Thapa Namisha, Alison H. Goldin, Walter W. Chan
Summary: This retrospective cohort study analyzed the relationship between recent opioid use in constipated patients and anorectal sensation, defecatory function, and balloon expulsion. Results showed that recent opioid use was associated with anorectal dysfunction and difficulty in passing stools.
DIGESTIVE DISEASES AND SCIENCES
(2022)
Article
Pharmacology & Pharmacy
M. Banasiuk, M. Dobrowolska, B. Skowronska, J. Konys, A. Chorazyk, E. Szudejko, A. Banaszkiewicz
Summary: This study evaluated constipated children with 3DHRAM and determined a new pediatric cut-off for DD variables. The analysis showed that the percent anal relaxation during straining significantly differed between patients and controls, leading to a new cut-off value of 31% for this variable.
EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES
(2021)
Letter
Gastroenterology & Hepatology
Jordi Serra, Daniel Pohl, Fernando Azpiroz, Giuseppe Chiarioni, Philippe Ducrotte, Guillaume Gourcerol, Amrit Pali S. Hungin, Peter Layer, Juan-Manuel Mendive, Johann Pfeifer, Gerhard Rogler, Mark Scott, Magnus Simren, Peter Whorwell
NEUROGASTROENTEROLOGY AND MOTILITY
(2020)
Letter
Cardiac & Cardiovascular Systems
Andrea Dalbeni, Michele Bevilacqua, Isabella Teani, Ilaria Normelli, Fulvia Mazzaferri, Giuseppe Chiarioni
NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES
(2021)
Letter
Gastroenterology & Hepatology
Yoav Mazor, Michael Jones, Allison Malcolm
NEUROGASTROENTEROLOGY AND MOTILITY
(2021)
Review
Medicine, General & Internal
Stefan L. Popa, Abdulrahman Ismaiel, Pop Cristina, Mogosan Cristina, Giuseppe Chiarioni, Liliana David, Dan L. Dumitrascu
Summary: This review provides a comprehensive overview of current studies on the application of artificial intelligence in the diagnosis and staging of NAFLD, demonstrating the accurate capacity of AI-based software for automated diagnosis and staging in NAFLD patients. The automated diagnosis methods analyzed in the studies include imagistic techniques, digital pathology, and electronic health records.
Article
Gastroenterology & Hepatology
Yoav Mazor, Rose Qizhengyan Trieu, Gillian Prott, Michael Jones, Anastasia Ejova, John Kellow, Allison Malcolm
Summary: Rectal perception testing is associated with various disease states, highlighting its clinical relevance, but there is limited agreement between different thresholds, suggesting they may measure different pathophysiological pathways. It is recommended that all three thresholds be measured and reported separately in routine clinical testing to enhance the analysis and interpretation of test results.
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2021)
Article
Gastroenterology & Hepatology
Arnold Wald, Adil E. Bharucha, Berkeley Limketkai, Allison Malcolm, Jose M. Remes-Troche, William E. Whitehead, Massarat Zutshi
Summary: These guidelines summarize the preferred approach to the evaluation and management of benign anorectal disorders, representing the official practice recommendations of the American College of Gastroenterology. They are considered as preferred but not the only approaches to these conditions.
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2021)
Editorial Material
Gastroenterology & Hepatology
Allison Malcolm
Letter
Gastroenterology & Hepatology
Arnold Wald, Adil E. Bharucha, Allison Malcolm, Jose M. Remes-Troche
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2022)
Review
Gastroenterology & Hepatology
Adil E. Bharucha, Guido Basilisco, Allison Malcolm, Tae Hee Lee, Matthew B. Hoy, S. Mark Scott, Satish S. C. Rao
Summary: Anorectal manometry is a comprehensive method for assessing anorectal sensorimotor functions, which is useful for diagnosing defecatory disorders and guiding management. The rectal balloon expulsion test is a convenient and cost-effective outpatient assessment tool for evaluating impaired evacuation.
NEUROGASTROENTEROLOGY AND MOTILITY
(2022)
Article
Gastroenterology & Hepatology
Sade L. Assmann, Daniel Keszthelyi, Jos Kleijnen, Foteini Anastasiou, Elissa Bradshaw, Ann E. Brannigan, Emma Carrington, Giuseppe Chiarioni, Liora D. A. Ebben, Marc A. Gladman, Yasuko Maeda, Jarno Melenhorst, Giovanni Milito, Jean W. M. Muris, Julius Orhalmi, Daniel Pohl, Yvonne Tillotson, Mona Rydningen, Saulius Svagzdys, Carolynne J. Vaizey, Stephanie O. Breukink
Summary: The project aimed to create an evidence-based European clinical practice guideline for the diagnosis and treatment of faecal incontinence. The guidelines were created in collaboration with different medical societies and included input from a patient advisory board. The guidelines included systematic literature searches, quality assessment, and the formulation of recommendations. Overall, there were 45 recommendations on the classification, diagnosis, and management of faecal incontinence in adult patients.
UNITED EUROPEAN GASTROENTEROLOGY JOURNAL
(2022)
Article
Medicine, General & Internal
Adil E. Bharucha, Charles H. Knowles, Isabelle Mack, Allison Malcolm, Nicholas Oblizajek, Satish Rao, S. Mark Scott, Andrea Shin, Paul Enck
Summary: Faecal incontinence is the unintentional loss of solid or liquid stool, which can significantly impact quality of life. Risk factors for this condition include bowel disturbances, anal sphincter trauma, and chronic illnesses. Treatment options vary based on severity and etiology, ranging from simple measures to diagnostic testing and non-surgical or surgical interventions.
NATURE REVIEWS DISEASE PRIMERS
(2022)
Article
Gastroenterology & Hepatology
Adam I. I. Kaplan, Yoav Mazor, Gillian M. M. Prott, Carol Sequeira, Michael P. Jones, Allison Malcolm
Summary: Recent community-based studies have found that having multiple concurrent functional gastrointestinal disorders (FGIDs) is associated with increased somatization, worse quality of life (QoL), and greater healthcare utilization. However, the presence of multiple overlapping FGIDs specifically in chronic constipation and functional defecation disorders (FDD) has not been studied. This study investigated the prevalence and impact of additional nonconstipation FGIDs on constipation severity, anorectal physiology, anxiety and depression, and QoL in patients with chronic constipation and FDD.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Gastroenterology & Hepatology
Rose Qizhengyan Trieu, Gillian Prott, Carol Sequeira, Michael Jones, Yoav Mazor, Margaret Schnitzler, Allison Malcolm
Summary: This study aimed to assess the alterations in defecatory posture and simulated defecation with the use of a footstool in constipated patients. The results showed that although the use of a footstool changed the defecatory posture, it did not improve the subjective or objective measures of simulated defecation in constipated patients. Therefore, the recommendation for using a footstool during evacuation cannot be applied to all constipated patients.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Review
Nutrition & Dietetics
Giuseppe Chiarioni, Stefan Lucian Popa, Abdulrahman Ismaiel, Cristina Pop, Dinu Iuliu Dumitrascu, Vlad Dumitru Brata, Traian Adrian Duse, Victor Incze, Teodora Surdea-Blaga, Jose Antonio Uranga
Summary: This systematic review evaluates the efficacy and safety of herbal remedies in the management of IBS-C. The included studies demonstrate some evidence of the beneficial effects of herbal remedies on IBS-C symptoms. However, the heterogeneity of the interventions and outcome measures limits the ability to perform a meta-analysis.
Review
Nutrition & Dietetics
Giuseppe Chiarioni, Stefan Lucian Popa, Abdulrahman Ismaiel, Cristina Pop, Dinu Iuliu Dumitrascu, Vlad Dumitru Brata, Traian Adrian Duse, Victor Incze, Teodora Surdea-Blaga
Summary: This systematic review provides evidence supporting the beneficial effects of polyphenols, minerals, fibers, and fruits in individuals with IBS. Dietary fiber supplementation, particularly soluble fiber, has been found to reduce bloating and improve stool consistency. However, further well-designed trials are needed due to the heterogeneity of the included studies and the limited number of high-quality randomized controlled trials.