To address the challenges of capturing micro-strains in detecting esophageal motility disorders and the limitations of existing high-resolution manometry and functional intraluminal imaging probes in directly measuring esophageal tissue electrical impedance, this study proposes a novel flexible balloon sensor structure that integrates a piezoelectric film assembly with a distributed impedance electrode array. Using the electrical analysis module in the finite element analysis (FEA) software, simulations of the forward problem for esophageal impedance detection were conducted to optimize the excitation source parameters, and a physical prototype was fabricated. Under a relative excitation mode with a voltage sensitivity of 2.059%, the voltage output characteristics of the impedance electrode array were analyzed during linear changes in the balloon filling volume. Based on the performance variation of the piezoelectric film assembly, 80% was selected as the optimal filling volume. Force-electric coupling tests were conducted on the balloon sensor using a pressure testing platform, revealing that both the piezoelectric film assembly inside the balloon and the impedance electrodes outside the balloon exhibited significant load differentiation characteristics as the force application point shifted. In summary, this balloon sensor facilitates the localization of force application while simultaneously analyzing esophageal tissue properties, offering a novel diagnostic approach and objective tool for esophageal disease detection.
Esophagus/physiology* ; Electric Impedance ; Humans ; Finite Element Analysis ; Manometry/methods* ; Electrodes ; Esophageal Motility Disorders/physiopathology* ; Equipment Design

OBJECTIVES: To investigate the characteristics and clinical significance of anorectal manometry measurements in children with tethered cord syndrome (TCS) before and after surgery. METHODS: A retrospective study was conducted on 44 children with TCS treated at the Children's Hospital of Zhejiang University School of Medicine from January 2022 to September 2023. These patients were divided into effective subgroup (n=34) and non-effective subgroup (n=10) based on postoperative symptom improvement. Additionally, 34 children with functional constipation were selected as a control group. Baseline data and manometry measurements were compared between the preoperative TCS group and the control group, as well as between the non-effective and effective subgroups. RESULTS: The TCS group had lower short contraction time and defecation relaxation rate compared to the control group (P<0.05), while defecation residual pressure and maximum rectal tolerable threshold were higher than the control group (P<0.05). The length of the anal canal in the high-pressure zone in the effective subgroup was greater postoperatively than preoperatively (P<0.05), and the initial rectal sensation threshold decreased postoperatively (P<0.05). The non-effective subgroup had lower preoperative maximum rectal expulsion pressure compared to the effective subgroup (P<0.05). Postoperative rectal anal inhibition reflex values in the effective subgroup were higher than those in the non-effective subgroup (P<0.05). CONCLUSIONS There are some differences in anorectal dynamics between children with TCS and those with functional constipation. Maximum rectal expulsion pressure may be a key predictor of surgical outcomes. Surgery can alter certain defecation functions in some children.
Humans ; Male ; Anal Canal/physiopathology* ; Female ; Rectum/physiopathology* ; Child ; Child, Preschool ; Retrospective Studies ; Manometry ; Neural Tube Defects/physiopathology* ; Infant ; Defecation ; Adolescent ; Constipation/physiopathology* ; Clinical Relevance

Chronic constipation is a common functional bowel disease, and its diagnosis is based on history and physical examination. Laboratory examination is important for determining the cause, type, severity and treatment effect of chronic constipation. At present, the commonly used workup of chronic constipation includes X-ray, magnetic resonance, pelvic floor ultrasound, neuroelectrophysiology and colorectal manometry, etc., which are recommended in many constipation diagnosis and treatment guidelines, but there has been no consensus on various examination indications, examination methods, judgment criteria and clinical value norms in detail. Led by the Anorectal Physicians Branch of the Chinese Medical Doctor Association, the editorial department of the Chinese Journal of Gastrointestinal Surgery convened domestic experts in related fields to summarize and sort out common laboratory examination methods for chronic constipation in combination with the latest evidence-based medical evidence at home and abroad, and conducted evidence quality assessment and recommendation strength classification according to the GRADE system. The Chinese Expert Consensus on the Examination and Evaluation of Chronic Constipation (2024 edition) was thus formed to help and guide the standardized examination in clinical practice and accurately interpret its clinical value.
Humans ; China ; Chronic Disease ; Consensus ; Constipation/diagnosis* ; Magnetic Resonance Imaging ; Manometry/methods*

Child ; Humans ; Manometry ; Esophagus/physiology*

In recent years, colonic manometry has been gradually introduced into clinical practice. It helps clinicians to gain a better understanding of the physiology and pathophysiology of colonic contractile activity in healthy adults and patients with colonic dysfunction. More and more patterns of colonic motility are being discovered with the help of colonic manometry. However, the clinical significance of these findings still needs to be further investigated. This review enhances our understanding of colonic motility and the current state of development and application of colonic manometry, as well as the limitations, future directions and potential of the technique in assessing the impact of treatment on colonic motility patterns, by analyzing and summarizing the literature related to colonic manometry.
Humans ; Adult ; Gastrointestinal Motility/physiology* ; Colon/physiology* ; Colonic Diseases ; Manometry/methods* ; Clinical Relevance ; Constipation

Humans ; Esophagus ; Manometry ; Botulinum Toxins/therapeutic use* ; Prostheses and Implants ; Treatment Outcome ; Larynx, Artificial

Colonic and anorectal manometry includes anorectal manometry and colonic manometry. Anorectal manometry is a common method to evaluate anorectal function, which can objectively reflect the pathological and physiological abnormalities of outlet obstructive constipation and fecal incontinence, as well as the impact of anorectal surgery on continence. Colonic manometry is a new type of colon motility detection method developed in recent years. It can record the peristalsis and contraction of the whole colon through a pressure measuring catheter, which helps physicians further evaluate various colonic diseases. However, various factors such as testing equipment, operating standards, and evaluation parameters are difficult to unify. There is no consensus on the operation and interpretation of colorectal anal pressure measurement. Under the guidance of the Anorectal Branch of Chinese Medical Doctor Association, in collaboration with Clinical Guidelines Committee, Anorectal Branch of Chinese Medical Doctor Association, Anorectal motility disorders Committee , Colorectal Surgeons Branch of Chinese Medical Doctor Association, Colonic Branch of China international exchange and promotive association for medical and healthcare, Tianjin Union Medical Center is leading the organization of domestic experts in this field. Based on searching relevant literature and combining clinical experience at home and abroad, after multiple discussions, the "Chinese expert consensus on colonic and anorectal manometry" has been prepared. This consensus discusses the indications, contraindications, pre examination management and technical procedures, treatment of complications, and interpretation of examination reports for colonic and anorectal manometry , aiming to guide the standardized clinical practice of colonic and anorectal manometry.
Humans ; Rectum ; Consensus ; Constipation ; Anal Canal ; Rectal Diseases ; Fecal Incontinence ; Manometry/methods* ; Colorectal Neoplasms/complications*

Fecal incontinence is one of the common diseases in the field of colorectal and anal surgery. Its etiology is complex, the treatment response is suboptimal, and there are controversies in clinical care. There is no consensus on the clinical practice of fecal incontinence in China currently. Launched by Anorectal Branch of Chinese Medical Doctor Association, Expert Committee on Anorectal Disease of Anorectal Branch of Chinese Medical Doctor Association, and Clinical Guidelines Committee of Anorectal Branch of Chinese Medical Doctor Association, and organized by the editorial board of Chinese Journal of Gastrointestinal Surgery, Chinese experts on this field were convened to write the Chinese expert consensus on clinical practice of fecal incontinence based on relevant references. After rounds of discussion, the final consensus combines the latest evidence and experts' clinical experience. This expert group suggested that a comprehensive assessment of fecal incontinence should be conducted before treatment, including medical history, relevant scales, physical examination and special examinations. Special examinations include anorectal endoscopy, anorectal manometry, transrectal ultrasound, magnetic resonance, rectal sensation and compliance, balloon ejection test, pelvic floor electromyography, defecography, colonoscopy and pudendal nerve terminal motor latency. Treatment methods include life style modification, medication, surgery, traditional Chinese medicine and other treatments. This consensus aims to standardize the algorithm of fecal incontinence management and improve therapeutic efficacy.
Humans ; Fecal Incontinence/etiology* ; East Asian People ; Manometry/adverse effects* ; Rectal Diseases/complications* ; Anal Canal/innervation*

INTRODUCTION: We aimed to provide a practical and evidence-based guide on the indications, performance and reporting of high-resolution oesophageal manometry (HRM) and ambulatory pH monitoring (PHM) in adult patients in Singapore. METHODS: The guideline committee comprised local gastroenterologists from public and private sectors with particular expertise in aspects of HRM and PHM, and it was tasked to produce evidence-based statements on the indications, performance and reporting of these tests. Each committee member performed literature searches to retrieve relevant articles within the context of domains to which they were assigned. RESULTS: Twelve recommendation statements were created and summarised. CONCLUSION Standardising key aspects of HRM and PHM is imperative to ensure the delivery of high-quality care. We reported the development of recommendations for the performance and interpretation of HRM and ambulatory reflux monitoring in Singapore.
Adult ; Esophageal pH Monitoring ; Esophagus ; Humans ; Hydrogen-Ion Concentration ; Manometry ; Singapore

PURPOSE: The Oral-anal Transit Test (OTT) is a simple method of obtaining information about colonic transit. We aim to assess the correlation of OTT with the neuromuscular integrity of the colon determined by colonic manometry (CM).METHODS: All patients who had OTT followed by CM were evaluated. Less than 6 of 24 markers remaining on OTT was considered normal. CM was performed per previously published guidelines. A normal CM was defined as at least one High Amplitude Propagating Contraction progressing from the most proximal sensor through the sigmoid colon.RESULTS: A total of 34 patients underwent both OTT and CM (44% male, age 4–18 years, mean 11.5 years, 97% functional constipation +/− soiling, Hirschsprung's Disease). Of normal and abnormal OTT patients, 85.7% (6/7) and 18.5% (5/27) respectively had normal CM. When all markers progressed to at least the sigmoid colon, this was 100% predictive against colonic inertia. Greater than 50% of patients with manometric isolated sigmoid dysfunction had markers proximal to the recto-sigmoid.CONCLUSION: OTT and CM are both valuable studies that assess different aspects of colonic function. OTT can be used as a screening test to rule out colonic inertia. However, the most proximal extent of remaining markers does not predict the anatomical extent of the manometric abnormality, particularly in isolated sigmoid dysfunction.
Child ; Colon ; Colon, Sigmoid ; Constipation ; Fecal Incontinence ; Humans ; Male ; Manometry ; Mass Screening ; Methods ; Soil