What question did this study set out to answer?

The aim is to investigate whether evaluating bear down patterns in a seated position can better predict outcomes in balloon expulsion testing.

February 14, 2026

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

Key Points

The aim is to investigate whether evaluating bear down patterns in a seated position can better predict outcomes in balloon expulsion testing.
Analyzed 384 adults undergoing anorectal manometry in both left lateral decubitus and seated positions.
Assessed for dyssynergia during anorectal manometry.
Applied logistic regression to evaluate associations with balloon expulsion testing outcomes.
Only 3.9% of participants normalized dyssynergic patterns in the seated position.
Normalization in the seated position resulted in significantly higher odds of successful balloon expulsion testing.
Odds ratio of 30.31 indicates a strong association with successful outcomes.

Abstract

Background: Bear down patterns during anorectal manometry (ARM) are classically evaluated in the left lateral decubitus (LLD) position. Testing in the seated position may more accurately reflect functional outcomes. Methods: 384 adults undergoing ARM were assessed for dyssynergia in the LLD and seated positions. Logistic regression evaluated associations with BET outcomes. Results: 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 4.09–3871.75; p<0.0001). Conclusions: Testing in the seated position may more reasonably predict BET success. A seated assessment may enhance diagnostic accuracy in defecation disorders.

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Cite This Study

Wang et al. (Thu,) studied this question.

synapsesocial.com/papers/699011a12ccff479cfe587af https://doi.org/https://doi.org/10.14309/ajg.0000000000003951

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