J Neurogastroenterol Motil 2019; 25(2): 250-257  
High-resolution Anorectal Manometry in the Diagnosis of Functional Defecation Disorder in Patients With Functional Constipation: A Retrospective Cohort Study
Yan Zhao,1 Xiaoyang Ren,1 Wen Qiao,1 Lei Dong,2 Shuixiang He,1* and Yan Yin1*
1Department of Gastroenterology, First Affiliated Hospital of Xi’an Jiaotong University, Shaanxi, China; and 2Department of Gastroenterology, Second Affiliated Hospital of Xi’an Jiaotong University, Shaanxi, China
Correspondence to: *Shuixiang He, MD
Department of Gastroenterology, First Affiliated Hospital of Xi’an Jiaotong University, 277 West Yanta Road, Xi’an, Shaanxi 710061, China, Tel: +86-2985323112, Fax: +86-2985323112, E-mail: hesx123@126.com
Yan Yin, MD
Department of Gastroenterology, First Affiliated Hospital of Xi’an Jiaotong University, 277 West Yanta Road, Xi’an, Shaanxi 710061, China, Tel: +86-2985323112, Fax: +86-2985323112, E-mail: yy1100002763@xjtu.edu.cn
Shuixiang He and Yan Yin are equally responsible for this study.
Received: February 14, 2018; Revised: January 25, 2019; Accepted: February 26, 2019; Published online: April 30, 2019.
© 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: High-resolution anorectal manometry (HRAM) has been considered a first-line diagnostic tool for functional defecation disorder. However, clinical studies on HRAM used in constipation patients are very limited and few studies have reported the characteristics of anorectal pressure in Chinese patients. The aim of this study is to investigate the characteristics of motility data in a cohort of Chinese patients with functional constipation.
Methods: A total of 82 consecutive patients with functional constipation who underwent a standardized HRAM were retrospectively enrolled in this study. The functional defecation disorder was classified into Rao’s types.
Results: The mean age of 82 patients was 51 years (range, 16-83 years). Indications for anorectal manometry were functional constipation for all patients. The mean resting pressure was 69.2 ± 21.2 mmHg (range, 24.5-126.9 mmHg). The mean maximum squeezing pressure was 198.4 ± 75.6 mmHg (range, 54.2-476.9 mmHg). The mean length of the anal high pressure zone was 3.4 ± 1.0 cm (range, 0.6-4.9 cm). Sixty (73.2%) patients were diagnosed as functional defecation disorder. In attempted defecation, type I was most common (n = 24), followed by type II (n = 12), type III (n = 11), and type IV (n = 13) that were present on HRAM according to Rao’s classification. In all 60 patients with functional defecation disorder, 37 were women and 23 were men. Men were significantly more likely than women to have functional defecation disorder (92.0% vs 64.9%, P = 0.014).
Conclusion: HRAM could be used as a test for the diagnosis of functional defecation disorder and functional defecation disorder is common in Chinese patients with functional constipation.
Keywords: Defecation; Humans; Manometry; Pressure


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