Manometric Analysis of the Rectosigmoid Junction
Research type
Research Study
Full title
A pilot study to examine an extended portion of the anorectum using high resolution water perfused manometry to determine the presence of physiological abnormality within common anorectal disorders.
IRAS ID
147067
Contact name
Elisa Wrightham
Contact email
Sponsor organisation
Salford Royal Foundation Trust, Research and Development
Duration of Study in the UK
0 years, 6 months, 30 days
Research summary
45 volunteers will be recruited to one of three groups (n=15 each); normal bowel function, chronic constipation and faecal incontinence. All participants will be provided with a rectal suppository to take on the night before the investigation to ensure that the lower bowel is clear and allow easier passage of the catheter. A detailed history will be obtained from each participant including symptoms and their duration, medication, surgical and obstetric history. Any risks associated with the test will be explained to participants and written, informed consent obtained prior to the procedure.
A procedure called High Resolution Anorectal Manometry will be performed on each participant to measure the internal pressure from the sigmoid colon to the anal canal. The catheter will be inserted 22cm transanally, through the rectosigmoid junction (RSJ) and into the sigmoid colon. Pressure will be recorded, pulling the catheter out 1cm at a time, and the presence of any increased pressure zones will be recorded. If increased pressure is detected at the RSJ, the length of this high pressure zone will be measured through stationary recording for a minimum of 60 seconds.
Standard anorectal manometry will also be performed on patients with normal bowel function, to ensure no underlying physiological abnormality. This involves measuring pressure in the anal canal and rectum and asking the participants to perform certain manoeuvres to analyse the function and coordination of the anorectal manoeuvres. Such manoeuvres will include squeezes, coughs and bearing down. A small balloon will also be inflated within the rectum and the participant will be asked to indicate the point at which they feel particular sensations, during the inflation. This will provide information concerning rectal capacity and sensation.
If a high pressure zone is detected at the RSJ, the presence of this will be recorded in participants of normal bowel function to begin to establish a normal range for this pressure. These values will then be compared to the pressures recorded in participants of the chronic constipation and faecal incontinence groups, to determine whether this pressure may be increased or decreased with these conditions. .
Statistical analysis will be performed on the data obtained and if the differences between pressures are determined to be significant, this may indicate a possible cause of the patients’ symptoms.REC name
North West - Greater Manchester South Research Ethics Committee
REC reference
14/NW/1303
Date of REC Opinion
21 Jan 2015
REC opinion
Further Information Favourable Opinion