4 Comparing anorectal function tests 99 left lateral position. Patients were asked to use a MICROLAX® enema the night before and the morning of the test. Pressures were measured at rest, during squeeze and during straining according to the London protocol (Carrington IAPWG 2019). Analysis of the manometry data was performed with ManoView (Given Imaging, Duluth, GA, USA). The mean resting pressure (MRP) and mean squeeze pressure (MSP) were measured by the software and were additional visually reviewed by the gastroenterologist RF. Fig 1 and fig 2 shows examples of the pressure profile during rest (MBP) and during squeeze (MSP) with ManoView. Normal values have been published by several authors and show a large range.14,23-28 Based on these studies we considered an anal rest or squeeze pressure lower than 50 mmHg as ‘low’. For comparison with the other tests, the anal pressures were categorized as described in Table 1. Figure 1. 3D-HRAM. Normal pressure profile during rest (MBP), increase during squeeze (MSP) and decrease during straining (ST). Figure 2. 3D-HDRAM. Dyssynergia. A high basal pressure (MBP) profile is seen with no changes in pressure during maximal squeeze (MSP) and straining (ST).
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