Department of Gastroenterology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China.
Department of Gastroenterology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
Med Sci Monit. 2024 Nov 7;30:e944599. doi: 10.12659/MSM.944599.
BACKGROUND Functional constipation can occur in children and adults and consists of difficult or infrequent bowel movements, painful defecation, or the sensation of incomplete bowel movement, and it can be idiopathic. This study aimed to compare the findings from high-resolution anorectal manometry (HRAM) and the balloon expulsion test (BET) in 360 patients with functional constipation and 73 healthy volunteers. MATERIAL AND METHODS In total, 360 patients with functional constipation and 73 healthy volunteers underwent HRAM and BET in our hospital from January 2017 to December 2023. We collected the general data of all participants and surveyed the defecation symptoms of patients with functional constipation. RESULTS Our study showed no significant correlation between HRAM results and age in healthy volunteers, while men had a higher residual anal pressure (P=0.022), higher anal squeeze pressure (P=0.020), and lower rectoanal pressure gradient than women (P=0.017). Using logistic regression analysis, it was concluded that sex (OR=2.880, 95% CI [1.654,5.015], P=0.000) and sensation of incomplete evacuation (OR=1.892, 95% CI [1.023,3.500], P=0.042) affected the occurrence of dyssynergic defecation. The specificity of BET in diagnosing dyssynergic defecation was 81.89%, while that of HRAM was 52.78%. CONCLUSIONS This observation provides normal values for anorectal pressures by HRAM. HRAM and BET are effective methods for assessing functional constipation. Being male and having sensation of incomplete evacuation are risk factors for dyssynergic defecation. The specificity of BET for diagnosing dyssynergic defecation was higher than that of HRAM.
功能性便秘可发生于儿童和成人，其特征为排便困难或不频繁、排便疼痛或有未排尽感，且可能为特发性。本研究旨在比较 360 例功能性便秘患者和 73 名健康志愿者的高分辨率肛门直肠测压（HRAM）和球囊排出试验（BET）结果。
2017 年 1 月至 2023 年 12 月，我们在医院对 360 例功能性便秘患者和 73 名健康志愿者进行了 HRAM 和 BET。我们收集了所有参与者的一般数据，并对功能性便秘患者的排便症状进行了调查。
我们的研究表明，健康志愿者的 HRAM 结果与年龄无显著相关性，而男性的残余肛门压力（P=0.022）、肛门收缩压（P=0.020）更高，直肠肛管压力梯度（P=0.017）更低。通过逻辑回归分析，得出性别（OR=2.880，95%CI[1.654,5.015]，P=0.000）和排不尽感（OR=1.892，95%CI[1.023,3.500]，P=0.042）是影响协同性排便障碍发生的因素。BET 诊断协同性排便障碍的特异性为 81.89%，而 HRAM 为 52.78%。
本观察提供了 HRAM 肛门直肠压力的正常值。HRAM 和 BET 是评估功能性便秘的有效方法。男性和排不尽感是协同性排便障碍的危险因素。BET 诊断协同性排便障碍的特异性高于 HRAM。
