Examining Balloon Expulsion Testing as an Office-Based, Screening Test for Dyssynergic Defecation: A Systematic Review and Meta-Analysis

The American Journal of Gastroenterology
Eric D ShahWilliam D Chey

Abstract

Balloon expulsion testing (BET) is recommended to evaluate for dyssynergic defecation in patients with chronic constipation (CC). However, it remains poorly standardized and is limited to specialized centers. Our goal was to assess the clinical utility of balloon expulsion as an initial test for dyssynergic defecation and to determine appropriate testing parameters. We performed a literature search to identify cohort studies of unselected subjects with CC and case-control studies of subjects with/without dyssynergic defecation. We defined dyssynergic defecation by constipation symptoms and a positive reference test (anorectal manometry [ARM], defecography, or electromyography [EMG]). We performed a meta-analysis using a bivariate mixed-effects regression model to assess summary sensitivity, specificity, and area under the curve (AUC) with 95% confidence intervals (CI). We conducted a meta-regression to investigate individual test parameters and demographic variables. We identified 15 eligible studies comprising 2090 individual assessments of BET. Among cohort studies, the AUC was 0.80 (95% CI: 0.61-0.91) with 70% sensitivity (95% CI: 52-83%) and 77% specificity (95% CI: 70-82%). In pooling cohort and case-control studies, the A...Continue Reading

References

Sep 1, 1987·Diseases of the Colon and Rectum·P N JonesM M Henry
Feb 1, 1986·Gastroenterology·P Shouler, M R Keighley
Jul 22, 1998·The American Journal of Gastroenterology·S S RaoJ S Leistikow
Feb 4, 1999·Scandinavian Journal of Gastroenterology·A GliaJ E Akerlund
Oct 3, 2003·The New England Journal of Medicine·Anthony Lembo, Michael Camilleri
Apr 30, 2004·Statistics in Medicine·Michael J SweetingPaul C Lambert
Oct 27, 2004·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·S S C RaoB Zimmerman
Mar 24, 2005·The American Journal of Gastroenterology·Davendra Ramkumar, Satish S C Rao
Jun 30, 2005·The American Journal of Gastroenterology·Satish S C RaoLoren Laine
Sep 20, 2005·Journal of Clinical Epidemiology·Johannes B ReitsmaAeilko H Zwinderman
Oct 10, 2006·The American Journal of Gastroenterology·Satish S C RaoSheila Rao
Apr 10, 2008·The American Journal of Gastroenterology·Nicholas J Talley
Jun 19, 2008·The American Journal of Gastroenterology·Nilay D ShahNicholas J Talley
Sep 16, 2008·Journal of Pain and Symptom Management·G Lindsay McCreaMadhulika G Varma
Nov 21, 2008·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·M CamilleriA Wald
Jan 27, 2009·Gastroenterology·James E Everhart, Constance E Ruhl
Dec 17, 2010·Diseases of the Colon and Rectum·Liliana BordeianouAbdulmetin Dursun
May 25, 2011·The American Journal of Gastroenterology·Nicole C Suares, Alexander C Ford
Aug 22, 2012·The American Journal of Gastroenterology·Ron ScheySatish S C Rao
Dec 25, 2012·Gastroenterology·Adil E BharuchaAmanda Pressman
Feb 21, 2013·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·E J VidelockF Cremonini
Aug 21, 2013·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·S RatuapliA R Zinsmeister
Mar 29, 2014·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Giuseppe ChiarioniWilliam E Whitehead
Jul 16, 2014·The American Journal of Gastroenterology·Arnold WaldWilliam E Whitehead
Feb 25, 2015·The Indian Journal of Radiology & Imaging·Ravikumar B ThaparVipul Chemburkar
Mar 25, 2015·The American Journal of Gastroenterology·Thomas SommersAnthony Lembo
Oct 30, 2015·BMJ : British Medical Journal·Patrick M BossuytUNKNOWN STARD Group
Jan 1, 2016·Journal of Neurogastroenterology and Motility·Tae Hee Lee, Adil E Bharucha
May 5, 2016·Gastroenterology·Satish Sc RaoArnold Wald
May 8, 2016·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·S PalitS M Scott
Jun 21, 2016·Environmental Research·Bill Sacks, Jeffry A Siegel
Nov 29, 2016·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·M ZakariK Staller
Nov 8, 2017·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Tanisa PatcharatrakulSatish S C Rao

❮ Previous
Next ❯

Citations

Feb 1, 2019·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·Yoav MazorAllison Malcolm
Aug 8, 2020·Digestive Diseases and Sciences·Leila NeshatianEamonn M Quigley
Jun 12, 2019·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·Giuseppe Chiarioni, William E Whitehead
May 27, 2020·Drugs·Jasper PannemansJan Tack
Mar 28, 2021·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·Alexandra R OrtengrenEric D Shah
Dec 6, 2021·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·William D CheyEric D Shah
Jan 10, 2022·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Eden KooBorko Nojkov

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Digestive Diseases and Sciences
Naeem Raza, Klaus Bielefeldt
Tropical Gastroenterology : Official Journal of the Digestive Diseases Foundation
Akash Shukla, Shobna J Bhatia
Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society
S RatuapliA R Zinsmeister
© 2022 Meta ULC. All rights reserved