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. Author manuscript; available in PMC: 2014 Apr 26.

Published in final edited form as: Am J Gastroenterol. 2012 Aug 21;107(11):1624–p.1634. doi: 10.1038/ajg.2012.247

A: HRM image of a healthy control showing manometric and topographic features during an attempted defecation maneuver. The upper part of the panal shows pressure changes from the rectum indicating that subject generated a good push effort. The lower part of the panel shows topographic images from the entire anal canal and puborectalis showing that both the anal sphincter and puborectalis relaxed normally with a significant drop in pressure. The location of sensors from the anal verge and the pressure gauge as represented by the various colors are also shown.

B: HRM image of a patient with constipation showing manometric and topographic features during two attempted defecation maneuvers. The upper part of the panal shows pressure changes from the rectum indicating that patient generated a good push effort. The lower part of the panel shows topographic images from the entire anal canal and puborectalis showing that both the anal sphincter and puborectalis exhibited paradoxical anal contraction, typical of dyssynergic defection. The location of sensors from the anal verge and the pressure gauge as represented by the various colors are also shown.

A: HRM image of a healthy control showing manometric and topographic features during an attempted defecation maneuver. The upper part of the panal shows pressure changes from the rectum indicating that subject generated a good push effort. The lower part of the panel shows topographic images from the entire anal canal and puborectalis showing that both the anal sphincter and puborectalis relaxed normally with a significant drop in pressure. The location of sensors from the anal verge and the pressure gauge as represented by the various colors are also shown.

B: HRM image of a patient with constipation showing manometric and topographic features during two attempted defecation maneuvers. The upper part of the panal shows pressure changes from the rectum indicating that patient generated a good push effort. The lower part of the panel shows topographic images from the entire anal canal and puborectalis showing that both the anal sphincter and puborectalis exhibited paradoxical anal contraction, typical of dyssynergic defection. The location of sensors from the anal verge and the pressure gauge as represented by the various colors are also shown.