Application value of high resolution anorectal manometry in phenotypic identification and classification of functionality dysporia

doi:10.3969/j.issn.1002-7386.2017.08.014

Abstract：Objective To investigate the application value of high resolution anorectal manometry in phenotypic identification and classification of functional dysporia in order to contribute to the diagnosis and treatment of functionality dysporia.Methods The basic data and clinical symptoms about 62 healthy subjects (control group) and 295 patients with chronic constipation (case group) were collected and analyzed.The rectal dynamics parameters were detected by high resolution anorectalmanometry and rectal balloon expulsion test.Finally the results were analyzed and compared between two groups.Results There were significant differences in the balloon expulsion time and sex proportion between two groups ( P <0.05).Moreover there were significant differences in the numbers of patients with anus obstruction feeling between the patients with longer balloon expulsion time and the patients with normal balloon expulsion time ( P <0.05).As compared with those in control group,the anus contractive pressure, rectal pressure during stimulation defecation and anus relaxation degree in case group were significantly decreased ( P <0.05), however,the anus pressure during stimulation defecation, differential pressure of anus/rectum, defecation sensory threshold in case group were obviously higher than those in control group ( P <0.05).Moreover the anus resting pressure,anus pressure during stimulation defecation, differential pressure of anus/rectum in patients with longer balloon expulsion time were even higher than those of patients with normal balloon expulsion time ( P <0.05),and anus pressure and anus relaxation degree were lower ( P <0.05).The initial threshold, defecation sensory threshold and maximum tolerated dose in patients with longer balloon expulsion time were obviously increased ( P <0.05).Conclusion The detection results for the key parameters of rectal dynamics can identify three important phenotypes: high anus pressure,low rectum pressure,mixed type,which can discriminate the patients with dysporia among patients with normal balloon expulsion time or abnormal balloon expulsion time.Moreover these phenotypes may be helpful to the researches about the pathological mechanism of functionality dysporia.