alexa Digital rectal examination is a useful tool for identifying patients with dyssynergia.


Journal of Pain & Relief

Author(s): Tantiphlachiva K, Rao P, Attaluri A, Rao SS

Abstract Share this page

Abstract BACKGROUND & AIMS: Dyssynergic defecation is a common cause of chronic constipation; its diagnosis requires anorectal physiological tests that are not widely available. It is not known whether digital rectal examination (DRE) can be used to identify dyssynergia. We examined the diagnostic yield of DRE in patients with dyssynergic defecation. METHODS: Consecutive patients with chronic constipation (Rome III criteria, n = 209) underwent DREs, anorectal manometry analyses, balloon expulsion tests, and colonic transit studies. In the DRE, dyssynergia was identified by 2 or more of the following features: impaired perineal descent, paradoxic anal contraction, or impaired push effort; diagnostic yields were compared with physiological test results. RESULTS: Of the patients included in the study, 187 (87\%) had dyssynergic defecation, based on standard criteria; 134 (73\%) of these were identified to have features of dyssynergia, based on DREs. The sensitivity and specificity of DRE for identifying dyssynergia in patients with chronic constipation were 75\% and 87\%, respectively; the positive predictive value was 97\%. DRE was able to identify normal resting and normal squeeze pressure in 86\% and 82\% of dyssynergic patients, respectively. CONCLUSIONS: DRE appears to be a reliable tool for identifying dyssynergia in patients with chronic constipation and detecting normal, but not abnormal, sphincter tone. DREs could facilitate the selection of appropriate patients for further physiologic testing and treatment. Copyright © 2010 AGA Institute. Published by Elsevier Inc. All rights reserved. This article was published in Clin Gastroenterol Hepatol and referenced in Journal of Pain & Relief

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version