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The utility of conditioning sequences in barostat protocols for the measurement of rectal compliance
Author(s) -
Bajwa A.,
Thiruppathy K.,
Emmanuel A.
Publication year - 2013
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.12109
Subject(s) - barostat , medicine , distension , rectum , compliance (psychology) , anesthesia , surgery , psychology , social psychology
Aim A barostat can be used to measure rectal sensitivity, compliance and elastance all of which are potentially important physiological parameters in the pathophysiology of faecal incontinence. Current practice recommends a conditioning distension sequence be performed prior to index distensions. We questioned the validity of this by comparing values for rectal compliance during sequential conditioning ( CD ) and index ( ID ) distensions in physiologically normal subjects. Method Ten subjects (five men, mean age 55.2 years) with normal anal canal manometry, anorectal sensitivity and balloon distension thresholds were studied. After determining the minimum distension pressure, subjects underwent sequential isobaric distensions: CD 4 mmHg distensions every 45 s and ID 4 mmHg every 2 min, both to a maximum of 24 mmHg or patient tolerance. Compliance values from both sequences were calculated by measuring the maximum slope of pressure–volume curves. A paired t ‐test was performed to compare any differences between sequences. Results Mean rectal compliance were 11.4 ml/mmHg ( SD 5.8 ml/mmHg) and 10.9 ml/mmHg ( SD 5.7 ml/mmHg) in the CD and ID , respectively, with no statistical difference noted between distensions ( P = 0.78). Conclusion Rectal compliance can be measured with a single distension protocol without the need for an initial conditioning distension. Conditioning the rectum adds additional complexity to barostat protocols and is not necessary.