{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T18:17:17Z","timestamp":1791656237992,"version":"4.3.4"},"reference-count":85,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T00:00:00Z","timestamp":1721865600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T00:00:00Z","timestamp":1721865600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100030719","name":"National Institute of Health Sciences","doi-asserted-by":"publisher","award":["R01 DK 121003\u20105"],"award-info":[{"award-number":["R01 DK 121003\u20105"]}],"id":[{"id":"10.13039\/100030719","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100030719","name":"National Institute of Health Sciences","doi-asserted-by":"publisher","award":["R01 DK 131488\u201001"],"award-info":[{"award-number":["R01 DK 131488\u201001"]}],"id":[{"id":"10.13039\/100030719","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100030719","name":"National Institute of Health Sciences","doi-asserted-by":"publisher","award":["UO1 DK 115571\u201005"],"award-info":[{"award-number":["UO1 DK 115571\u201005"]}],"id":[{"id":"10.13039\/100030719","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anorectal motility disorders such as dyssynergic defecation (DD), faecal incontinence (FI) and anorectal pain affect 40% of the population and are a frequent reason for gastroenterology consultation. They significantly affect the quality of life and lead to psychological distress. Lack of understanding of these problems compounded by a lack of availability and knowledge of diagnostic tools in most medical centres and\/or trained physicians has significantly hampered this field.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To discuss the latest advances in pathophysiology, diagnostic tests and therapeutic options for these disorders using an evidence\u2010based approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We reviewed the published literature over the past 20\u2009years on DD, FI and anorectal pain and distilled these into a narrative review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A detailed history, prospective stool diary and digital rectal exam, together with diagnostic tests such as anorectal manometry, balloon expulsion test, translumbosacral anorectal magnetic stimulation test for assessing neuropathy, defecography and anal ultrasound, can provide detailed mechanistic and structural information. Such knowledge can pave the way for a meaningful and pathophysiologic\u2010based management approach. This could include biofeedback therapy for DD or FI, sensory training for rectal hyposensitivity or sensory adaptation training for rectal hypersensitivity or sphincter bulking agents or neuromodulation therapies. These treatments are effective and safe.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Anorectal motility disorders are common, but either less well recognized or poorly managed by most gastroenterologists. Equipped with the practical and up\u2010to\u2010date knowledge provided in this review, physicians could provide improved health care for these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.18170","type":"journal-article","created":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T07:11:09Z","timestamp":1721891469000},"page":"701-714","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Review article: advances in the diagnosis and management of anorectal motility disorders"],"prefix":"10.1111","volume":"60","author":[{"given":"Dariush","family":"Shahsavari","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Augusta University  Augusta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4446-8452","authenticated-orcid":false,"given":"Satish S. C.","family":"Rao","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Augusta University  Augusta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,25]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.08.002"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm20012"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00338.2013"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2003.10.013"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2021.10.004"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2012.247"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm16060"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.009"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.1999.00950.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2011.164"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e31820c6001"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-200523050-00006"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mcg.0000135929.78074.8c"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2006.03238.x"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000278"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.16369"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/003655299750025327"},{"key":"e_1_2_8_19_1","first-page":"232","volume-title":"Sleisenger and Fordtran's Gastrointestinal and Liver Disease","author":"Rao S","year":"2020"},{"key":"e_1_2_8_20_1","first-page":"21","article-title":"Validation of a prospective stool diary for assessment of constipation","volume":"2011","author":"Meduri KBC","year":"2011","journal-title":"Neurogastroenterol Motil"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0016\u20105085(20)31690\u20105"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.14309\/01.ajg.0000601040.60548.70"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365520510012208"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2017.12.026"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.10.049"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016;150:1430\u20131442"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.1998.00326.x"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41395-018-0006-y"},{"key":"e_1_2_8_29_1","unstructured":"Centres for Medicare & Medicaid Services.Revisions and clarifications to Hospital Interpretive Guidelines for Informed Consent. Published April 1 2024 [cited 2024 June 6]. Available from:https:\/\/www.cms.gov\/medicare\/health\u2010safety\u2010standards\/quality\u2010safety\u2010oversight\u2010general\u2010information\/policy\u2010memos\u2010states\/revisions\u2010and\u2010clarifications\u2010hospital\u2010interpretive\u2010guidelines\u2010informed\u2010consent"},{"key":"e_1_2_8_30_1","first-page":"1","article-title":"Anorectal manometry: when, how to perform and interpret, and is it useful?","volume":"00","author":"Frye J","year":"2024","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00827.x"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00604.x"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2003.10.044"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2017.95"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.160.4.8456664"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.13657"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2018.27"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12520"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.11.014"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2006.12.023"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12552"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14226"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0000000000001348"},{"key":"e_1_2_8_44_1","unstructured":"Adult diapers market size share & trends analysis report by type (tape on diapers pant\/pull\u2010up type pad type) by region (North America Europe APAC LATAM MEA) and segment forecasts 2019\u20132025.https:\/\/www.grandviewresearch.com\/industry\u2010analysis\/adult\u2010diapers\u2010market"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.04.006"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14714"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(19)37721-2"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800760934"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800750119"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2982.2002.00352.x"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2010.478"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-007-0391-y"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2008.06.008"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01536422"},{"key":"e_1_2_8_55_1","first-page":"2539","article-title":"Comparison of anal sonography with conventional needle electromyography in the evaluation of anal sphincter defects","volume":"91","author":"Enck P","year":"1996","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_8_56_1","article-title":"Biofeedback and\/or sphincter exercises for the treatment of faecal incontinence in adults","volume":"2","author":"Norton C","year":"2000","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_57_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01297069"},{"key":"e_1_2_8_58_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12360"},{"key":"e_1_2_8_59_1","doi-asserted-by":"publisher","DOI":"10.1093\/gastro\/gou004"},{"key":"e_1_2_8_60_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365529950173762"},{"key":"e_1_2_8_61_1","first-page":"CD001310","article-title":"Electrical stimulation for faecal incontinence in adults","volume":"2007","author":"Hosker G","year":"2007","journal-title":"Cochrane Database Syst Rev"},{"issue":"3","key":"e_1_2_8_62_1","article-title":"Sacral nerve stimulation for faecal incontinence and constipation in adults","volume":"2007","author":"Mowatt G","year":"2007","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_63_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-864079"},{"key":"e_1_2_8_64_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000186281.09475.db"},{"key":"e_1_2_8_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)15999-0"},{"key":"e_1_2_8_66_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60314-2"},{"key":"e_1_2_8_67_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000766"},{"key":"e_1_2_8_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2017.08.023"},{"key":"e_1_2_8_69_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)05218-6"},{"key":"e_1_2_8_70_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e3182468c22"},{"key":"e_1_2_8_71_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1997.tb02040.x"},{"key":"e_1_2_8_72_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14168"},{"key":"e_1_2_8_73_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02048363"},{"key":"e_1_2_8_74_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-020-02317-3"},{"key":"e_1_2_8_75_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002268"},{"key":"e_1_2_8_76_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02050352"},{"key":"e_1_2_8_77_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v17.i40.4447"},{"key":"e_1_2_8_78_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2009.12.040"},{"key":"e_1_2_8_79_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(19)37720-0"},{"key":"e_1_2_8_80_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.20393"},{"key":"e_1_2_8_81_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2009.03964.x"},{"key":"e_1_2_8_82_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-019-01945-8"},{"key":"e_1_2_8_83_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-006-0754-4"},{"issue":"6","key":"e_1_2_8_84_1","first-page":"450","article-title":"Proctalgia fugax in patients with the irritable bowel, peptic ulcer, or inflammatory bowel disease","volume":"79","author":"Thompson WG","year":"1984","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_8_85_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002394"},{"key":"e_1_2_8_86_1","first-page":"1","article-title":"Assessment of anorectal disorders","volume":"72","author":"Jehangir A","year":"2021","journal-title":"Gastroenterol Endoscopy News"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.18170","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/apt.18170","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.18170","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T11:14:03Z","timestamp":1771326843000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.18170"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,25]]},"references-count":85,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1111\/apt.18170"],"URL":"https:\/\/doi.org\/10.1111\/apt.18170","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,25]]},"assertion":[{"value":"2024-04-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}