Contribution of Posture to Anorectal Manometric Measurements: Are the Measurements in Left-Lateral Position Physiologic?

• Published in: Diseases of the colon & rectum Vol. 50; no. 12; pp. 2112 - 2119
• Main Authors: Thekkinkattil, Dinesh K, Lim, Michael K, Nicholls, Marcus J, Sagar, Peter M, Finan, Paul J, Burke, Dermot A
• Format: Journal Article
• Language: English
• Published: Secaucus, NJ The ASCRS 01-12-2007; Springer; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Adult; Aged; Biological and medical sciences; Fecal Incontinence - diagnosis; Fecal Incontinence - physiopathology; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Male; Manometry - methods; Medical sciences; Middle Aged; Other diseases. Semiology; Posture - physiology; Pressure; Prognosis; Rectum - physiopathology; Rest - physiology; Severity of Illness Index; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Manometry; Vector volume; Fecal incontinence; Left; Lateral; Anorectal manometry; Anorectal; Pressure gradient; Maximum mean resting pressure; Posture; Postural change; Erect posture; Digestive diseases; Intestinal disease; Anal incontinence; Resting pressure gradient; Vector; Anorectal disease
• ISSN: 0012-3706; 1530-0358
• DOI: 10.1007/s10350-007-9043-0

PURPOSE:
METHODS:
RESULTS:Complete data were available for 172 patients. Median age was 55 (interquartile range, 44-65) years. Thirty-seven (22 percent) patients were continent, and 135 (78 percent) were incontinent. Both resting pressure and vector volume increased significantly in the erect position for both continent (P = 0.008 and 0.001, respectively) and incontinent (P = 0.001 for both) patients. A significant negative correlation was seen between severity of incontinence and resting pressure in the erect posture and amount of change in maximum mean resting pressure from left-lateral to erect posture (Spearman coefficients = −0.203, −0.211, and P = 0.013, 0.017, respectively) but not with maximum mean resting pressure in the left-lateral position (Spearman coefficient = −0.119; P = 0.164).
CONCLUSIONS: