Rectal balloon inflation during the push manoeuvre

  • Research type

    Research Study

  • Full title

    What effect does an inflated rectal balloon have on the change in anal canal pressure during the push manoeuvre in Anorectal Manometry? A pilot study.

  • IRAS ID

    232548

  • Contact name

    Anne Moran

  • Contact email

    Anne.Moran@UHBristol.nhs.uk

  • Sponsor organisation

    University Hospitals Bristol NHS Foundation Trust

  • Duration of Study in the UK

    0 years, 4 months, 28 days

  • Research summary

    Anorectal Manometry tests measure pressure in the anal canal and rectum. These tests can help diagnose the cause of bowel symptoms such incontinence or constipation. To measure pressure, a short flexible tube (anorectal catheter) is placed in the patient’s bottom. Measurements taken include resting tone (how tight the anal muscles are when resting), squeeze pressure (how tightly a person can squeeze their anal muscles) and a push manoeuvre (what happens to the anal muscles when a person 'pushes' down). At the end of the catheter is a small flat balloon, which is inflated to measure rectal sensations.

    When defecating, the anal muscles should relax to allow stools out. During Anorectal Manometry, a fall in pressure should be seen when a person 'pushes'. However, the opposite effect is extremely common. When the anal muscles contract instead of relaxing, this is known as paradoxical anal sphincter contraction.

    This research study aims to compare the push manoeuvre with and without inflating the balloon at the end of the catheter first. Inflating the balloon should give a person the sensation that they need to open their bowels, as they would normally have when using the toilet. Paradoxical anal sphincter contraction may be over-reported when the push manoeuvre is completed without any sensation that the person needs to defecate.

    Four push manoeuvres will be measured during participants’ normal Anorectal Manometry investigation, two with the rectal balloon inflated with 60 ml of air and two without the balloon inflated. This will extend the Anorectal Manometry study by approximately 4 minutes. Normally, only two push manoeuvres would be performed, without any air in the rectal balloon. There are no additional risks associated, and participants will not need to attend any extra appointments.

  • REC name

    London - Queen Square Research Ethics Committee

  • REC reference

    17/LO/1880

  • Date of REC Opinion

    23 Nov 2017

  • REC opinion

    Favourable Opinion