Digital Rectal Examination and Balloon Expulsion Test in the Study of Defecatory Disorders: Are They Suitable as Screening or Excluding Tests?

Table 3

Summary of studies with digital rectal examination.

Study reference		Gender; (fem)	Age; (y)	DRE; (used criteria)	Comparative test; (used criteria)	Se	Sp	PPV	NPV
[37]	268	152	64	2 of as-pc/as-nr, pe-i, pd-a	HRM (type I–IV DD)	93	59	91	66
[28]	209	18	41	2 of as-pc/as-nr, am-nc, pd-a	ARM + BET or CTT pr-p or pr-nr, ne, stt	73	85	97	31
[36]	168		44	pr-pc	ARM + CTT	83	95	98	65
[47]	136			pr-pc	DEF + EMG aa-ni, i	58	88	62	87

DRE: digital rectal examination, HRM: high resolution manometry, ARM: anorectal manometry, DEF: defecography, EMG: electromyography, and CCT: colonic transit time.
DRE: as-pc (anal sphincter paradoxical contraction), as-nr (anal sphincter nonrelaxing), am-nc (abdominal muscles not contracted), pd-a (perineal descent absent), and pe-i (push effort impaired).
HRM or ARM: pr-pc (puborectalis paradoxical contraction) or pr-nr (puborectalis nonrelaxing).
DEF: aa-ni (anorectal angle not increased).
EMG: i (activity increased).
CTT: stt (slow transit time).
BET: ne (not expelling a 50 mL water balloon in 1 minute).