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 referenceGender
(fem)
Age
(y)
BET (simulated stool, volume (mL), body position, time (min))Comparative test (used criteria)SeSpPPVNPV

[39]616150W 50 S 2HRM and/or DEF pr-pc or pr-nr, ce-i33807145
[34]23626444W 50 S 2ARM pr-pc or pr-nr85717780
[11]1008053W 50 S 3ARM pr-pc60110052
[5]524935W 50 S 5ARM pr-pc or pr-nr94758986
[40]29529548W 50 S 3HRM pr-pc or pr-nr29783970
[41]13225652A 50 S 2ARM pr-pc or pr-nr76929280
[33]13012438W SD S 1ARM + DEF pr-pc or pr-nr, ce-i88896497
[42]463446A 20 SDEF ce-i41928263
[43]13411252W 60 SDEF ce-i or ce-f37887164
[45]7465W 10DEF ce-i or ce-f87635191
[14]3246W 50EMG i75889554
[35]353044W 50 S 5ARM + DEF/CTT pr-pc or pr-nr, ce-i, stt89768087
[13]12311851A 60 S 5DEF ce-i52585754

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).