Normalization of Dyssynergic Bear Down Patterns in the Seated Position Predicts Normal Balloon Expulsion Testing on High-Resolution Anorectal Manometry.

Wang, Catherine Y; McLennan, Logan; Patel, Ritam H; Yarlagadda, Swati; Shramuk, Maxwell E; Liu, Joy J; Brenner, Darren M · Am J Gastroenterol · 2026

retrospective_cohort · Level III

Where this comes from

Abstract

Bear down patterns during anorectal manometry are classically evaluated in the left lateral decubitus position. Testing in the seated position may more accurately reflect functional outcomes. Overall, 384 adults undergoing anorectal manometry were assessed for dyssynergia in the left lateral decubitus and seated positions. Logistic regression evaluated associations with balloon expulsion testing (BET) outcomes. Normalization of dyssynergic patterns in the seated position occurred in 3.9% (n = 19) resulting in higher odds of successful BET (<1 minute) (OR 30.31; 95% CI 4.09-3,871.75; P < 0.0001). Testing in the seated position may more reasonably predict BET success. A seated assessment may enhance diagnostic accuracy in defecation disorders.