A high-resolution anorectal manometry parameter based on integrated pressurized volume

A study based on 204 male patients with constipation and 26 controls

M. Seo, S. Joo, K. W. Jung, J. Lee, H. J. Lee, J. S. Soh, I. J. Yoon, H. S. Koo, S. Y. Seo, D. Kim, S. W. Hwang, S. H. Park, D. H. Yang, B. D. Ye, J. S. Byeon, H. Y. Jung, S. K. Yang, Satish Sanku Chander Rao, S. J. Myung

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Conventional anorectal manometric parameters based on linear waves cannot properly predict balloon expulsion (BE) time. We aimed to determine the correlation between integrated pressurized volume (IPV) parameters during simulated evacuation (SE) and BE time in healthy individuals and constipated patients and to assess the correlation between each parameter and symptoms. Methods: A total of 230 male participants (including 26 healthy volunteers and 204 chronically constipated patients) underwent high-resolution anorectal manometry (HRAM) and BE tests. The IPV was calculated by multiplying the amplitude, distance, and time from the HRAM profile. Receiver operating characteristic curve (ROC) analysis and partial least square regression (PLSR) were performed. Key Results: ROC analysis indicated that the IPV ratio between the upper 1 cm and lower 4 cm of the anal canal was more effective for predicting BE time (area under the curve [AUC]: 0.74, 95% confidence interval [CI]: 0.67-0.80, P <.01) than the conventional anorectal parameters, including defecation index and rectoanal gradient (AUC: 0.60, 95% CI: 0.52-0.67, P =.01). PLSR analysis of a linear combination of IPV parameters yielded an AUC of 0.79. Moreover, the IPV ratio showed a greater clinical correlation with patient symptoms than conventional parameters. Conclusions and Inferences: The IPV parameters and the combination of IPV parameters via PLSR were more significantly correlated with BE time than the conventional parameters. Thus, this study presents a useful diagnostic tool for the evaluation of pathophysiologic abnormalities in dyssynergic defecation using IPV and BE time.

Original languageEnglish (US)
Article numbere13376
JournalNeurogastroenterology and Motility
Volume30
Issue number9
DOIs
StatePublished - Sep 1 2018

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Manometry
Constipation
Least-Squares Analysis
Area Under Curve
Defecation
ROC Curve
Confidence Intervals
Anal Canal
Healthy Volunteers
Regression Analysis

Keywords

  • constipation
  • dyssynergic defecation
  • high-resolution anorectal manometry

ASJC Scopus subject areas

  • Physiology
  • Endocrine and Autonomic Systems
  • Gastroenterology

Cite this

A high-resolution anorectal manometry parameter based on integrated pressurized volume : A study based on 204 male patients with constipation and 26 controls. / Seo, M.; Joo, S.; Jung, K. W.; Lee, J.; Lee, H. J.; Soh, J. S.; Yoon, I. J.; Koo, H. S.; Seo, S. Y.; Kim, D.; Hwang, S. W.; Park, S. H.; Yang, D. H.; Ye, B. D.; Byeon, J. S.; Jung, H. Y.; Yang, S. K.; Rao, Satish Sanku Chander; Myung, S. J.

In: Neurogastroenterology and Motility, Vol. 30, No. 9, e13376, 01.09.2018.

Research output: Contribution to journalArticle

Seo, M, Joo, S, Jung, KW, Lee, J, Lee, HJ, Soh, JS, Yoon, IJ, Koo, HS, Seo, SY, Kim, D, Hwang, SW, Park, SH, Yang, DH, Ye, BD, Byeon, JS, Jung, HY, Yang, SK, Rao, SSC & Myung, SJ 2018, 'A high-resolution anorectal manometry parameter based on integrated pressurized volume: A study based on 204 male patients with constipation and 26 controls', Neurogastroenterology and Motility, vol. 30, no. 9, e13376. https://doi.org/10.1111/nmo.13376
Seo, M. ; Joo, S. ; Jung, K. W. ; Lee, J. ; Lee, H. J. ; Soh, J. S. ; Yoon, I. J. ; Koo, H. S. ; Seo, S. Y. ; Kim, D. ; Hwang, S. W. ; Park, S. H. ; Yang, D. H. ; Ye, B. D. ; Byeon, J. S. ; Jung, H. Y. ; Yang, S. K. ; Rao, Satish Sanku Chander ; Myung, S. J. / A high-resolution anorectal manometry parameter based on integrated pressurized volume : A study based on 204 male patients with constipation and 26 controls. In: Neurogastroenterology and Motility. 2018 ; Vol. 30, No. 9.
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abstract = "Background: Conventional anorectal manometric parameters based on linear waves cannot properly predict balloon expulsion (BE) time. We aimed to determine the correlation between integrated pressurized volume (IPV) parameters during simulated evacuation (SE) and BE time in healthy individuals and constipated patients and to assess the correlation between each parameter and symptoms. Methods: A total of 230 male participants (including 26 healthy volunteers and 204 chronically constipated patients) underwent high-resolution anorectal manometry (HRAM) and BE tests. The IPV was calculated by multiplying the amplitude, distance, and time from the HRAM profile. Receiver operating characteristic curve (ROC) analysis and partial least square regression (PLSR) were performed. Key Results: ROC analysis indicated that the IPV ratio between the upper 1 cm and lower 4 cm of the anal canal was more effective for predicting BE time (area under the curve [AUC]: 0.74, 95{\%} confidence interval [CI]: 0.67-0.80, P <.01) than the conventional anorectal parameters, including defecation index and rectoanal gradient (AUC: 0.60, 95{\%} CI: 0.52-0.67, P =.01). PLSR analysis of a linear combination of IPV parameters yielded an AUC of 0.79. Moreover, the IPV ratio showed a greater clinical correlation with patient symptoms than conventional parameters. Conclusions and Inferences: The IPV parameters and the combination of IPV parameters via PLSR were more significantly correlated with BE time than the conventional parameters. Thus, this study presents a useful diagnostic tool for the evaluation of pathophysiologic abnormalities in dyssynergic defecation using IPV and BE time.",
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T1 - A high-resolution anorectal manometry parameter based on integrated pressurized volume

T2 - A study based on 204 male patients with constipation and 26 controls

AU - Seo, M.

AU - Joo, S.

AU - Jung, K. W.

AU - Lee, J.

AU - Lee, H. J.

AU - Soh, J. S.

AU - Yoon, I. J.

AU - Koo, H. S.

AU - Seo, S. Y.

AU - Kim, D.

AU - Hwang, S. W.

AU - Park, S. H.

AU - Yang, D. H.

AU - Ye, B. D.

AU - Byeon, J. S.

AU - Jung, H. Y.

AU - Yang, S. K.

AU - Rao, Satish Sanku Chander

AU - Myung, S. J.

PY - 2018/9/1

Y1 - 2018/9/1

N2 - Background: Conventional anorectal manometric parameters based on linear waves cannot properly predict balloon expulsion (BE) time. We aimed to determine the correlation between integrated pressurized volume (IPV) parameters during simulated evacuation (SE) and BE time in healthy individuals and constipated patients and to assess the correlation between each parameter and symptoms. Methods: A total of 230 male participants (including 26 healthy volunteers and 204 chronically constipated patients) underwent high-resolution anorectal manometry (HRAM) and BE tests. The IPV was calculated by multiplying the amplitude, distance, and time from the HRAM profile. Receiver operating characteristic curve (ROC) analysis and partial least square regression (PLSR) were performed. Key Results: ROC analysis indicated that the IPV ratio between the upper 1 cm and lower 4 cm of the anal canal was more effective for predicting BE time (area under the curve [AUC]: 0.74, 95% confidence interval [CI]: 0.67-0.80, P <.01) than the conventional anorectal parameters, including defecation index and rectoanal gradient (AUC: 0.60, 95% CI: 0.52-0.67, P =.01). PLSR analysis of a linear combination of IPV parameters yielded an AUC of 0.79. Moreover, the IPV ratio showed a greater clinical correlation with patient symptoms than conventional parameters. Conclusions and Inferences: The IPV parameters and the combination of IPV parameters via PLSR were more significantly correlated with BE time than the conventional parameters. Thus, this study presents a useful diagnostic tool for the evaluation of pathophysiologic abnormalities in dyssynergic defecation using IPV and BE time.

AB - Background: Conventional anorectal manometric parameters based on linear waves cannot properly predict balloon expulsion (BE) time. We aimed to determine the correlation between integrated pressurized volume (IPV) parameters during simulated evacuation (SE) and BE time in healthy individuals and constipated patients and to assess the correlation between each parameter and symptoms. Methods: A total of 230 male participants (including 26 healthy volunteers and 204 chronically constipated patients) underwent high-resolution anorectal manometry (HRAM) and BE tests. The IPV was calculated by multiplying the amplitude, distance, and time from the HRAM profile. Receiver operating characteristic curve (ROC) analysis and partial least square regression (PLSR) were performed. Key Results: ROC analysis indicated that the IPV ratio between the upper 1 cm and lower 4 cm of the anal canal was more effective for predicting BE time (area under the curve [AUC]: 0.74, 95% confidence interval [CI]: 0.67-0.80, P <.01) than the conventional anorectal parameters, including defecation index and rectoanal gradient (AUC: 0.60, 95% CI: 0.52-0.67, P =.01). PLSR analysis of a linear combination of IPV parameters yielded an AUC of 0.79. Moreover, the IPV ratio showed a greater clinical correlation with patient symptoms than conventional parameters. Conclusions and Inferences: The IPV parameters and the combination of IPV parameters via PLSR were more significantly correlated with BE time than the conventional parameters. Thus, this study presents a useful diagnostic tool for the evaluation of pathophysiologic abnormalities in dyssynergic defecation using IPV and BE time.

KW - constipation

KW - dyssynergic defecation

KW - high-resolution anorectal manometry

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