Deshmukh Rahul, Shukla Akash, Chandnani Sanjay, Rathi Pravin M, Tibdewal Pratik, Jain Shubham, Ramani Nitin, Junare Parmeshwar, Debnath Partha, Shinde Leela, Bagwan Asif, Meshram Megha
Department of Gastroenterology, Topiwala National Medical College and BYL Nair Ch Hospital, Mumbai, Maharashtra, India.
Department of Gastroenterology, KEM Hospital and Seth GS Medical College, Mumbai, Maharashtra, India.
J Neurogastroenterol Motil. 2022 Jul 30;28(3):401-408. doi: 10.5056/jnm21107.
BACKGROUND/AIMS: High-resolution anorectal manometry (HRAM) measures anal sphincter function and anorectal co-ordination. This study aims to provide normal data for HRAM and evaluate the effect of gender, age, and body mass index (BMI) on anorectal functions in healthy Indian subjects.
HRAM was performed on 93 healthy volunteers using a 20-channel, water-perfused catheter. We evaluated anorectal pressures, rectal sensation, and balloon expulsion time. Measurements were recorded during rest, squeeze, and simulated defecation (push).
Median anal resting pressure (88 mmHg vs 94 mmHg, = NS), anal squeeze pressure (165 mmHg vs 147 mmHg, = NS) were not significantly different between males and females. Rectal pressure (70 mmHg vs 54 mmHg, = 0.024) and anal pressure (82 mmHg vs 63 mmHg, = 0.008) during simulated evacuation without rectal distention, were higher in males. The threshold for the first sensation was lower in females (40 mL vs 30 mL, = 0.021) but desire to defecate (105 mL vs 90 mL, = NS) and maximum tolerable volume (160 mL vs 140 mL, = NS) were not significantly different in males and females. Anal residual pressure (median mmHg 83 vs 71 mmHg, = 0.025) was higher in subjects < 40 years of age. Maximum anal squeeze pressure (185 mmHg vs 165 mmHg, = 0.024) and maximum rectal pressure (75 mmHg vs 62 mmHg, = 0.032) during push higher in BMI < 23 kg/m.
The present study provides normal data for the Indian population that can be used for comparison and further work. Age, gender, and BMI affect anorectal parameters in HRAM and should be considered while reporting.
背景/目的：高分辨率肛肠测压法（HRAM）可测量肛门括约肌功能和肛肠协调性。本研究旨在提供HRAM的正常数据，并评估性别、年龄和体重指数（BMI）对健康印度受试者肛肠功能的影响。
使用20通道水灌注导管对93名健康志愿者进行HRAM检查。我们评估了肛肠压力、直肠感觉和球囊排出时间。在静息、收缩和模拟排便（推挤）期间记录测量值。
男性和女性之间的肛门静息压中位数（88 mmHg对94 mmHg，P = 无显著性差异）、肛门收缩压（165 mmHg对147 mmHg，P = 无显著性差异）无显著差异。在无直肠扩张的模拟排便期间，男性的直肠压力（70 mmHg对54 mmHg，P = 0.024）和肛门压力（82 mmHg对63 mmHg，P = 0.008）更高。女性首次感觉的阈值较低（40 mL对30 mL，P = 0.021），但男性和女性的排便欲望（105 mL对90 mL，P = 无显著性差异）和最大耐受量（160 mL对140 mL，P = 无显著性差异）无显著差异。年龄<40岁的受试者肛门残余压中位数（83 mmHg对71 mmHg，P = 0.025）更高。BMI<23 kg/m²的受试者在推挤时的最大肛门收缩压（185 mmHg对165 mmHg，P = 0.024）和最大直肠压力（75 mmHg对62 mmHg，P = 0.032）更高。
本研究为印度人群提供了可用于比较和进一步研究的正常数据。年龄、性别和BMI会影响HRAM中的肛肠参数，在报告时应予以考虑。
