Intra-subject Variability in High Resolution Anorectal Manometry Using the London Classification: Diagnostic and Therapeutic Implications

• Published in: Digestive diseases and sciences Vol. 67; no. 11; pp. 5014 - 5018
• Main Authors: Triadafilopoulos, George, Clarke, John O., Kamal, Afrin, Neshatian, Leila
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.11.2022; Springer; Springer Nature B.V
• Subjects: Anal Canal; Analysis; Anus; Biochemistry; Botulinum toxin; Brief Report; Classification; Clinical decision making; Constipation; Constipation - diagnosis; Decision-making; Fecal incontinence; Feces; Female; Gastroenterology; Health aspects; Hepatology; Humans; Irritable bowel syndrome; London; Male; Management decisions; Manometry; Medical colleges; Medical diagnosis; Medicine; Medicine & Public Health; Motility; Oncology; Pelvis; Physical therapy; Pilot Projects; Reproducibility of Results; Retrospective Studies; Transplant Surgery; London; Functional anorectal disorders; London classification; Constipation; High resolution anorectal manometry
• ISSN: 0163-2116; 1573-2568; 1573-2568
• DOI: 10.1007/s10620-021-07373-9

This retrospective pilot study conducted on a community-based cohort of both men and women of various ages and underlying clinical presentations examined the durability and reproducibility of HR-ARM findings influencing their potential impact on clinical decision-making at the point of care (Jameson et al. in Br J Surg 81:1689–1692, 1994). The key finding of our study was that only a minority of patients who underwent repeat anorectal manometry as analyzed by the London Classification had stable manometric findings, raising questions regarding the validity of a single manometric measurement, as currently analyzed, for clinical decision-making.