Comparison of AAR,FLIP and HRAM in Patients with Anorectal Dysfunction

  • Research type

    Research Study

  • Full title

    Anal Acoustic Reflectometry, FLIP and High Resolution Anorectal Manometry in the Assessment of Anal Sphincter Function in Patients with Anorectal Dysfunction

  • IRAS ID

    258927

  • Contact name

    Karen Telford

  • Contact email

    karen.telford2@mft.nhs.uk

  • Sponsor organisation

    Manchester University NHS Foundation Trust

  • Duration of Study in the UK

    1 years, 0 months, 26 days

  • Research summary

    Anorectal disorders include the conditions faecal incontinence (FI), disordered defecation and prolapse. These conditions can be devastating for the patient and can significantly affect their quality of life. They are common conditions and are present in up to 10% of the population. Up to this point high resolution anal manometry (HRAM) has been the gold standard test (i.e. the best recognised test) in assessment of these patients. Anal acoustic reflectometry (AAR) has been uniquely investigated in the Pelvic Floor Department at Manchester University NHS Foundation Trust since 2008. It is an exciting “catheter free technique” as it does not distort the anal canal/sphincter muscles. It simultaneously measures the cross-sectional area and pressures and therefore constructs a profile of how the anal canal muscles are functioning. It has demonstrated superiority, when compared to conventional anorectal manometry, in discriminating between faecally continent and incontinent patients. We are currently using AAR to study the effects of prolapse, in patient with FI, on the anal sphincter’s function and this study is showing early promising results. In addition to this research with AAR, another tool known as a Functional Lumen Imaging Probe (FLIP) is now commercially available, unlike AAR. FLIP also measures cross-sectional area but differs from AAR as it records distensibility of the anal canal and is not a “catheter free technique”. AAR and FLIP have never been directly compared with one another, nor have they both been used to study patients with anorectal dysfunction simultaneously. Comparing AAR, FLIP and HRAM will further improve our understanding and knowledge of anorectal function and facilitate management in patients with anorectal dysfunction.

  • REC name

    North West - Greater Manchester West Research Ethics Committee

  • REC reference

    19/NW/0633

  • Date of REC Opinion

    7 Oct 2019

  • REC opinion

    Favourable Opinion