J Neurogastroenterol Motil  
Evaluation of 153 Asymptomatic Subjects Using the Anopress Portable Anal Manometry Device
Cosimo Alex Leo,1,2* Emanuel Cavazzoni,3 Gregory P Thomas,1 Jonathan Hodgkison,1,2 Jamie Murphy ,2 and Carolynne J Vaizey1,2
1London North West NHS Trust - St Mark’s Hospital Academic Institute, Sir Alan Park’s Physiology Unit, Harrow, UK; 2Imperial College of London, UK; and 3Santa Maria della Misericordia Hospital, University of Perugia, Italy
Correspondence to: Cosimo Alex Leo, MBBS, MD
St Mark’s Hospital Academic Institute, 1, Watford Road HA1 3UJ, Middlesex, Harrow, UK
Tel: +44-020-8235-4046 (4048), Fax: +44-020-8235-4046 (4048), E-mail: a.leo@nhs.net
Received: November 24, 2017; Revised: February 5, 2018; Accepted: February 9, 2018; Published online: June 7, 2018.
© The Korean Society of Neurogastroenterology and Motility. All rights reserved.

cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background/Aims
The Anopress device is a new portable manometry system. The aim of this study is to formulate normative data using this new device by recording the anorectal function of asymptomatic subjects. Patient comfort was also assessed.
Methods
Anorectal function was assessed in asymptomatic volunteers using the Anopress. All volunteers were examined in a standardized way in accordance with the study protocol. Normative values for the Anopress were obtained from the recorded data and patient comfort was assessed using a visual analogue scale.
Results
We recruited 153 healthy volunteers. Eighty were female (23 parous; median age 39.5 [interquartile range {IQR}, 28.75-53.00]) and 73 were male (median age 40.5 [IQR, 29.00-52.25]). For the female cohort, the following normal range (2.5-97.5 percentile) values were recorded across the whole anal canal: resting pressure 40.0-103.0 mmHg; squeeze increment 35.0-140.6 mmHg; endurance 1.3-9.0 seconds; involuntary squeeze 41.1-120.8 mmHg; and strain pressure 22.1-77.9 mmHg. Similarly, the following male normal range (2.5-97.5 percentile) values were recorded across the whole anal canal: resting pressure 38.3-99.6 mmHg; squeeze increment 42.5-154.8 mmHg; involuntary squeeze 40.0-123.6 mmHg; endurance 2.0-10.0 seconds; and strain pressure 11.0-72.1 mmHg. The median visual analogue scale scores for all patients was 0.0 (0.00-0.00).
Conclusions
Normative values for the Anopress device have been calculated by this study. The Anopress appears to be a safe and well tolerated way of measuring pressures from the entire anal canal. Further comparisons with other standard and commonly used manometry tests are, however, required to verify its reliability.
Keywords: Anal canal; Manometry; Physiology; Pressure


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