Background Defecation is a complex process. Defecatory disorders may be assessed using rectal balloon expulsion test (BET), high-resolution anorectal manometry (HR-ARM) and defecography. We have developed a Fecobionics device that integrates several current tests1 to assess pressures, orientation and bending all at once by the patient bedside. The Fecobionics probe is 10 cm long, 12 mm in diameter with 8 cm long inflatable bag and pressure sensors at each end. It contains two gyroscopes to measure the orientation and bending during defaecation.
Aim To characterise physiological expulsion parameters in asymptomatic subjects using Fecobionics.
Methods Fecobionics was inserted into the rectum and subjects were asked to sit on a commode. The bag was filled with fluid until subjects had the sensation to defaecate. Patients were asked to expel the Fecobionics. Time to expulsion, pressures and bending angles were assessed during the expulsion. This was compared to conventional 5=BET and HR-ARM.
Results Eight subjects (6F/2M, 50 years (25–77)) were assessed. Defaecation urge was felt at 32±=. Five subjects expelled Fecobionics in one attempt. The expulsion time for Fecobionics and BET were 32.2±6.3 and 15.7±3.3 s respectively (p<0.05). Linear association was found between the duration of Fecobionics and BET expulsions (R2=0.48). During Fecobionics expulsion all pressure sensors showed elevated pressures. The front end pressure reached 20–50 cm/H2O above baseline rectal pressure during anal canal passage. Rear end pressure was 28.9±4.6 cm/H2O before expulsion to a maximum pressure of 144.7±15.7 cm/H2O during the expulsion. Defecations could be subdivided into five distinct phases based on the front and rear pressures and their pressure difference1. The bending angle was 137.2±9.6o before defaecation, 145.3±5.0o at maximum contraction, and 178.7±0.9o during anal passage (p<0.05); indicative of changes in the anorectal angle.
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