High-Resolution Anorectal Manometry - A Prospective Cohort Study in Healthy Infants
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Read the article on pubmed.ncbi.nlm.nih.gov ↗Article · Jan 2022 · 1 min read
In brief
In brief
Prospective study of 107 healthy infants establishes normative HRAM data at 2 and 6 months, demonstrating that RAIR is present in all healthy infants and anal resting pressure increases with age. Findings provide baseline reference values for evaluating suspected Hirschsprung disease and functional defecation disorders in this age group.
Written by the GCMD Library team from the article.
Objectives: Functional gastrointestinal disorders (FGD) are common during early childhood. In severe defecation disorders, anorectal manometry (AM) is done to exclude aganglionosis. High-resolution anorectal manometry (HRAM) can probably improve diagnostics but normative data in infants are scarce. This study aims to provide HRAM data in healthy infants overall and in subgroups of infants with FGD, defined as functional constipation (FC), infant colic (IC) and infant dyschezia (ID) (ROME 3 criteria).
Methods: This prospective observational cohort study enrolled healthy term infants, having HRAM at 2 and 6 months, using a water-perfused pediatric anorectal silicone catheter. Data was provided for presence of anorectal waves and recto anal inhibitory reflex (RAIR), volume needed to elicit RAIR and anal resting pressure (ARP). Questionnaires at 2 and 6 months identified subjects with FC, IC and ID.
Results: A total of 187 HRAM investigations were done in 107 infants, without any complications. Normal RAIR was found in all, at least at one occasion. Mean ARP increased between 2- and 6-month investigations in infants without FGD. No other differences in HRAM data could be seen between infants with or without an FGD. At 2 months FC, IC and ID were seen (2%, 4% and 17%), whereas at 6-months only FC and ID were seen (7% and 1%).
Conclusion: We can provide data on HRAM in infants at 2 and 6 months of age. When performing repeated HRAM in healthy infants, RAIR was found in all subjects. HRAM is safe, easy tolerable and can be recommended in infants with or without FGD.
DOI: 10.1097/MPG.0000000000003350