Purpose: The aim was to study High Resolution Anorectal Manometry (HRAM) in Egyptian population and the influence of age, gender and parity on manometric parameters.
Methods: We studied 22 healthy volunteers 10 males and 12 females with median age 42 y (range: 18-61 y) by using solid state probe with 8 transducers 1 cm spaced with a rectal balloon mounted at the tip. The system is plotting graphs with high resolution topography and conventional pressure waves trac- ing as well (Solar GI MMS). Probe was introduced through the anal verge so the balloon is located at the rectum and the sensors at the rectum and analcanal. External EMG electrodes were applied on either sides of anus. Subjects were asked to relax, squeeze the anal sphincter, bear down, and cough to meas- ure anal pressures at these situations. Rectal sensation and recto-anal inhibi- tory reflex (RAIR) were evaluated by stepwise intermittent (10 ml) balloon distention. Finally balloon expulsion test was done.
Results: Anal resting and maximum squeeze pressure were significantly higher in males than females (median; range: 61; 45-71 and 140.0; 67-224 vs. 42; 32-67 and 117; 58-220 respectively, P<0.05), while squeeze time, pressure increase to cough, push relaxation, RAIR, rectal sensation, and EMG were comparable in males and females. Age negatively correlated with some anorectal parameters (table 1), simi- larly parity negatively correlated with anal resting (r=-0.52, p <0.05) and squeeze pressure (r=-0.56, p<0.05). All subjects were able to expel the balloon. Conclusion: HRAM helps understanding anorectal physiology. It is influenced by age, gender, and parity. This study can aid in diagnosis anorectal dysfunc- tion in Egyptian population.