High Resolution Anorectal Manometry (HRARM) in Healthy Egyptian Population
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- Category: Vol. 79, December 2011
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High Resolution Anorectal Manometry (HRARM) in Healthy Egyptian Population,HALA M.K. IMAM and ESSAM ABDELMOHSEN
Abstract
Introduction: Individual motility laboratories should have their own published normal measurements based on their population, therefore, we needed to establish standard param-eters for the first application of HRARM in evaluation of anorectal function.
Aim of the Work: To evaluate the anorectal function by HRARM among a diverse of healthy Egyptian population in order to obtain normative data.
Methods: The study was done at gastrointestinal motility lab, Internal Medicine Department, Assiut University Hospital, during the period of June 2008-June 2010, on 43 healthy volunteers 24 males and 19 females with average 44y (quar-tiles: 35-50y). We used a solid state probe with 8 transducers spaced 0.8cm with a rectal balloon mounted at the tip. The probe was introduced through the anal verge so the balloon is located at the rectum and the sensors at the rectum and the anal canal. External EMG electrodes were applied on either sides of anus. Subjects were asked to relax, squeeze the anal sphincter, bear down, and cough to measure anal pressures at these situations. Rectal sensation and recto-anal inhibitory reflex (RAIR) were evaluated by stepwise intermittent (10ml) balloon distention. Finally balloon expulsion test was done.
Results: Anal resting and squeeze pressure were signifi-cantly lower, and anal canal was significantly shorter in women than men, while squeeze time, anal pressure increase with cough, push relaxation, RAIR, rectal sensation, and anal EMG were comparable in males and females. Age was nega-tively correlated with anal resting, anal squeeze pressure, and anal pressure increase to cough, while balloon expulsion time increased with age. Similarly, parity was negatively correlated with anal resting pressure. All subjects were able to expel the balloon.
Conclusion: HRARM helps in understanding anorectal physiology. It is influenced by age, gender, and parity. This study can aid in diagnosing anorectal dysfunction in Egyptian population.