Comparing anorectal manometry in the left lateral vs seated position
Research type
Research Study
Full title
Does performing the push manoeuvre in the seated position instead of left lateral during anorectal manometry improve its diagnostic accuracy in patients with functional defecation disorders?
IRAS ID
275871
Contact name
Dipesh Vasant
Contact email
Sponsor organisation
Manchester University NHS Foundation Trust
Clinicaltrials.gov Identifier
20/NW/0315 , REC reference
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Anorectal manometry (ARM) is a useful test to diagnose anorectal disorders such as severe forms of constipation and faecal incontinence, especially when medicines have failed. These symptoms can be devastating for patients and reduces their quality of life. In this situation, ARM can help select the right patients to receive specific, treatment with pelvic floor physiotherapy to improve the co-ordination and strength of the patients’ muscles. This type of treatment called biofeedback therapy has been shown to improve quality of life and symptoms in this situation. The test itself involves measuring pressures in the back passage using a thin tube (catheter) to see if the muscles of the pelvic floor are co-ordinated during straining. However, recently the role of ARM as a test for people with constipation has been questioned. This is after a recent research study surprisingly suggested that over 8 out of 10 healthy people have the same abnormalities on this test, as seen in those with anorectal disorders. The previous research was however done with participants attempting to defecate in an unnatural position on lying on their left hand side, instead of being seated on a commode, when straining. We suspect that the position of the participants could have affected the results of this study in healthy people and therefore the accuracy of measurements. Our research is therefore important to assess and clarify whether the accuracy and reliability of this test to diagnose anorectal disorders is better when people are seated in a more natural position during ARM. We also want to find out if people find the test in the natural position more dignified, acceptable and comfortable, than lying on their left hand side.
REC name
East of England - Cambridge South Research Ethics Committee
REC reference
20/EE/0197
Date of REC Opinion
6 Nov 2020
REC opinion
Further Information Favourable Opinion