Dataset Information

The international anorectal physiology working group (IAPWG) recommendations: Standardized testing protocol and the London classification for disorders of anorectal function.

ABSTRACT:

Background

This manuscript summarizes consensus reached by the International Anorectal Physiology Working Group (IAPWG) for the performance, terminology used, and interpretation of anorectal function testing including anorectal manometry (focused on high-resolution manometry), the rectal sensory test, and the balloon expulsion test. Based on these measurements, a classification system for disorders of anorectal function is proposed.

Methods

Twenty-nine working group members (clinicians/academics in the field of gastroenterology, coloproctology, and gastrointestinal physiology) were invited to six face-to-face and three remote meetings to derive consensus between 2014 and 2018.

Key recommendations

The IAPWG protocol for the performance of anorectal function testing recommends a standardized sequence of maneuvers to test rectoanal reflexes, anal tone and contractility, rectoanal coordination, and rectal sensation. Major findings not seen in healthy controls defined by the classification are as follows: rectoanal areflexia, anal hypotension and hypocontractility, rectal hyposensitivity, and hypersensitivity. Minor and inconclusive findings that can be present in health and require additional information prior to diagnosis include anal hypertension and dyssynergia.

Conclusions and inferences

This framework introduces the IAPWG protocol and the London classification for disorders of anorectal function based on objective physiological measurement. The use of a common language to describe results of diagnostic tests, standard operating procedures, and a consensus classification system is designed to bring much-needed standardization to these techniques.

SUBMITTER: Carrington EV

PROVIDER: S-EPMC6923590 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Publications

The international anorectal physiology working group (IAPWG) recommendations: Standardized testing protocol and the London classification for disorders of anorectal function.

Carrington Emma V EV Heinrich Henriette H Knowles Charles H CH Fox Mark M Rao Satish S Altomare Donato F DF Bharucha Adil E AE Burgell Rebecca R Chey William D WD Chiarioni Guiseppe G Dinning Philip P Emmanuel Anton A Farouk Ridzuan R Felt-Bersma Richelle J F RJF Jung Kee Wook KW Lembo Anthony A Malcolm Allison A Mittal Ravinder K RK Mion Franҫois F Myung Seung-Jae SJ O'Connell P Ronan PR Pehl Christian C Remes-Troche Jose María JM Reveille R Matthew RM Vaizey Carolynne J CJ Vitton Veronique V Whitehead William E WE Wong Reuben K RK Scott S Mark SM

Neurogastroenterology and motility 20190812 1

<h4>Background</h4>This manuscript summarizes consensus reached by the International Anorectal Physiology Working Group (IAPWG) for the performance, terminology used, and interpretation of anorectal function testing including anorectal manometry (focused on high-resolution manometry), the rectal sensory test, and the balloon expulsion test. Based on these measurements, a classification system for disorders of anorectal function is proposed.<h4>Methods</h4>Twenty-nine working group members (clini ...[more]

PMID: 31407463

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Dataset Information

The international anorectal physiology working group (IAPWG) recommendations: Standardized testing protocol and the London classification for disorders of anorectal function.

Background

Methods

Key recommendations

Conclusions and inferences

Publications

The international anorectal physiology working group (IAPWG) recommendations: Standardized testing protocol and the London classification for disorders of anorectal function.

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