Review Article
Digital Rectal Examination and Balloon Expulsion Test in the Study of Defecatory Disorders: Are They Suitable as Screening or Excluding Tests?
Table 2
Summary of studies with balloon expulsion test.
| Study reference | | Gender (fem) | Age (y) | BET (simulated stool, volume (mL), body position, time (min)) | Comparative test (used criteria) | Se | Sp | PPV | NPV |
| [39] | 61 | 61 | 50 | W 50 S 2 | HRM and/or DEF pr-pc or pr-nr, ce-i | 33 | 80 | 71 | 45 | [34] | 236 | 264 | 44 | W 50 S 2 | ARM pr-pc or pr-nr | 85 | 71 | 77 | 80 | [11] | 100 | 80 | 53 | W 50 S 3 | ARM pr-pc | 60 | 1 | 100 | 52 | [5] | 52 | 49 | 35 | W 50 S 5 | ARM pr-pc or pr-nr | 94 | 75 | 89 | 86 | [40] | 295 | 295 | 48 | W 50 S 3 | HRM pr-pc or pr-nr | 29 | 78 | 39 | 70 | [41] | 132 | 256 | 52 | A 50 S 2 | ARM pr-pc or pr-nr | 76 | 92 | 92 | 80 | [33] | 130 | 124 | 38 | W SD S 1 | ARM + DEF pr-pc or pr-nr, ce-i | 88 | 89 | 64 | 97 | [42] | 46 | 34 | 46 | A 20 S | DEF ce-i | 41 | 92 | 82 | 63 | [43] | 134 | 112 | 52 | W 60 S | DEF ce-i or ce-f | 37 | 88 | 71 | 64 | [45] | 74 | 65 | | W 10 | DEF ce-i or ce-f | 87 | 63 | 51 | 91 | [14] | 32 | | 46 | W 50 | EMG i | 75 | 88 | 95 | 54 | [35] | 35 | 30 | 44 | W 50 S 5 | ARM + DEF/CTT pr-pc or pr-nr, ce-i, stt | 89 | 76 | 80 | 87 | [13] | 123 | 118 | 51 | A 60 S 5 | DEF ce-i | 52 | 58 | 57 | 54 |
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BET: balloon expulsion test, HRM: high resolution manometry, ARM: anorectal manometry, DEF: defecography, EMG: electromyography, and CCT: colonic transit time. BET: W: water, A: air, SD: sustained desire to evacuate, and S: seated position. HRM or ARM: pr-pc (puborectalis paradoxical contraction) or pr-nr (puborectalis nonrelaxing). DEF: ce-i (contrast evacuation impaired) or ce-f (contrast evacuation failed in 30 s). EMG: i (activity increased). CTT: stt (slow transit time).
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