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Do I Have IBS?
Published in Melissa G. Hunt, Aaron T. Beck, Reclaim Your Life From IBS, 2022
Melissa G. Hunt, Aaron T. Beck
The tests for dyssynergia include balloon expulsion tests, anorectal manometry, and magnetic resonance defecography. All of these tests are designed to get a measure in real time of how the muscles are working together (or not) to expel stool. In a balloon expulsion test, a small balloon (about 4 centimeters) filled with warm water is inserted into the rectum and then you try to expel it. The result is how long it takes you to expel the balloon. In manometry, a slender device is inserted into the anus that records pressure in different places as you try to bear down. In a defecogram, the technician will insert a soft substance into your rectum that contains a contrast material (like barium) that shows up in the imaging. While you’re in the MRI, you’ll be asked to bear down or to relax, and the MRI will capture which muscles are contracting and when.
Fundoplication
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Douglas C. Barnhart, Robert A. Cina
Pressure recordings are made with continuously perfused, open-tipped catheters or solid-state pressure transducers. This allows assessment of resting pressures within the esophagus and assessment of esophageal motility. These findings are not specific or sensitive enough to diagnose pathologic gastroesophageal reflux. Manometry is useful in diagnosing alternative causes of esophageal symptoms such as motility disorders.
Medical Evaluation of Functional GI Disorders
Published in Kevin W. Olden, Handbook of Functional Gastrointestinal Disorders, 2020
Michael Camilleri, Jeffrey W. Frank
There are three main modalities for evaluation of esophageal functional disorders: esophageal manometry and prolonged and short reflux tests (16). Manometry is a method whereby a series of perfused catheters, with sideholes located at several levels of the esophagus, provide a pressure profile during swallowing of the contractions at different levels of the esophagus (Figure 3) (17). Alternatively, solid-state transducers can be used instead of perfused manometers (Figure 4). Diagnostic profiles are discussed elsewhere in this book. The main indications for esophageal manometry are: the evaluation of barium x-ray or en-doscopy-negative dysphagia, noncardiac chest pain, and in the preoperative assessment of patients about to undergo fundoplication or other hiatal hemia repair for reflux esophagitis.
Botulinum toxin injection is an effective alternative for the treatment of chronic anal fissure
Published in Acta Chirurgica Belgica, 2023
Of the six patients with relapsing disease, two preferred to be admitted to another center and four received secondary treatments. Anal manometry was performed on those four patients and revealed increased resting pressure in all of them. Of those four patients, three underwent repeat BTA injection and one underwent LIS. Of the three patients who received repeat BTA injection, two had a complete and one had a partial response (this patient refused further treatment and was satisfied with the treatment as it was). The patient who underwent LIS achieved a complete response. Of these four patents treated for relapsing disease, one patient who received repeat BTA injection had minor incontinence, and no continence problem was seen in the others. The median follow-up time was 24 (18–42) months. Figure 4 summarizes the results of patients with refractory and relapsing diseases.
Immediate effects of postural repositioning on maximum phonation duration tasks in seated individuals with acquired dysarthria: a pilot study
Published in Disability and Rehabilitation, 2022
Marie Julien, Maureen MacMahon, Dre Céline Lamarre, Dre Nicole Beaudoin, Jean-Michel Fortin, Dorothy Barthelemy
In terms of manometry, all PWDs benefited from postural repositioning, and the duration of manometry increased in all PWDs with the exception of the participant with mild dysarthria, whose average value was already over that of the control participants. As mentioned in the Materials and Methods section, it is important to note that the participant with mild dysarthria is the youngest participant (45 years old) and had relatively no physical incapacities. His overall physical condition was very good as he was walking several kilometers a day, which could explain the results. Hence, the four participants with moderate and severe dysarthria benefitted from postural repositioning, with a 30.7% mean improvement in the manometric results (10.4 s in the USP and 13.6 s in the CSP). According to Hixon et al. (1982), a duration of 5–10 s of respiratory subglottal pressure sufficient to produce functional speech is healthy [27]. In the present study, three PWDs could reach over 10 s in the USP and a fourth PWD could reach this duration in the CSP. In one participant with severe dysarthria, the duration of manometry was 3.9 s in the USP and reached 4.7 s in the CSP. According to Yorkston et al. [10], this 0.8-s difference (21.2% increase) almost reaches the 5 s minimum target for functional speech, and may be sufficient to have a positive effect on speech production.
Assessing symptomatic vulvar, vaginal, and lower urinary tract atrophy
Published in Climacteric, 2019
Vaginal pressure is a key measure of the strength of the pelvic floor muscles and vulvovaginal pain. Various measurement systems from vaginal electric waves (electrovaginogram) that could measure vaginal muscle contraction19 have been described. In addition, several devices – mostly pneumohydraulically perfused manometric systems measuring the vaginal distension capacity as well as distension and pressure when pain starts – have also been proposed20. Since then, several investigators have used various types of devices to measure vaginal pressure/force as a measure of when distension causes pain. Using a manometry technique that can measure contact pressure in general and at a point location, it is possible to determine if there is a pressure of distension where the patient begins to have discomfort and/or pain, and what is also relevant is to be able to indicate whether there is any more painful area or point. These data could allow one, first, to measure the degree of distension where the pain begins, second whether the prescribed treatment improves these results, and, third, also whether the pain is more localized, allowing more selective treatments19,20.