ANORECTAL MANOMETRY - TECHNIQUES AND CLINICAL-APPLICATIONS

Anorectal manometry has gained wide acceptance as a helpful method to objectively assess the apparatus of defecation provided by the anorect al sphincter. The standard manometric evaluation enables measurement o f resting and squeeze pressures, as well as of the length of the funct ional anal canal (high pressure zone [HPZ]). More detailed assessment of radial and longitudinal pressure profiles can also be generated fro m vector volume and vector symmetry index assessment. Adjuvant techniq ues using an intrarectal balloon allow assessment of the rectoanal inh ibitory reflex (RAIR), rectal sensitivity, capacity, and compliance. A lthough anorectal manometry can be used as a diagnostic test in diseas es such as Hirschsprung's disease, more often it is used to assess com mon disorders such as chronic idiopathic constipation and fecal incont inence. Anorectal manometry has also been considered as a preoperative evaluation in patients having abdominal and anorectal procedures duri ng which the state of continence can be jeopardized.