{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T17:43:59Z","timestamp":1785519839683,"version":"3.56.0"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T00:00:00Z","timestamp":1712534400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The functional lumen imaging probe (FLIP) is a test of anal sphincter distensibility under evaluation by specialist centers. Two measurement protocols termed \u201cstepwise\u201d and \u201cramp\u201d are used, risking a lack of standardization. This study aims to compare the performance of these protocols to establish if there are differences between them.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with fecal incontinence were recruited and underwent measurement with both protocols at a tertiary pelvic floor referral unit. Differences in minimum diameter, FLIP bag pressure, and distensibility index (DI) at rest and during squeeze were calculated at various FLIP bag volumes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Twenty patients (19 female, mean age 61 [range: 38\u201378]) were included. The resting minimum diameter at 30 and 40\u2009mL bag volumes were less in the stepwise protocol (mean bias: \u22120.55\u2009mm and \u22121.18\u2009mm, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) along with the DI at the same bag volumes (mean bias: \u22120.37\u2009mm<jats:sup>2<\/jats:sup>\/mmHg and \u22120.55\u2009mm<jats:sup>2<\/jats:sup>\/mmHg, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). There was also a trend towards greater bag pressures at 30\u2009mL (mean bias: +2.08\u2009mmHg, <jats:italic>p<\/jats:italic>\u2009=\u20090.114) and 40\u2009mL (mean bias: +2.81\u2009mmHg, <jats:italic>p<\/jats:italic>\u2009=\u20090.129) volumes in the stepwise protocol. There were no differences between protocols in measurements of minimum diameter, maximum bag pressure, or DI during voluntary squeeze (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion and Inferences<\/jats:title><jats:p>There are differences between the two commonly described FLIP measurement protocols at rest, although there are no differences in the assessment of squeeze function. Consensus agreement is required to agree the most appropriate FLIP measurement protocol in assessing anal sphincter function.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14791","type":"journal-article","created":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T09:33:39Z","timestamp":1712568819000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A comparison of function lumen imaging probe measurements of anal sphincter function in fecal incontinence"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3964-9152","authenticated-orcid":false,"given":"Alexander","family":"O'Connor","sequence":"first","affiliation":[{"name":"Department of General Surgery, Wythenshawe Hospital Manchester University NHS Foundation Trust  Manchester UK"},{"name":"Division of Diabetes, Endocrinology &amp; Gastroenterology Faculty of Biology, Medicine and Health The University of Manchester, Manchester Academic Health Sciences Centre  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3908-6537","authenticated-orcid":false,"given":"Donghua","family":"Liao","sequence":"additional","affiliation":[{"name":"Mech\u2010Sense, Department of Gastroenterology and Hepatology Aalborg University Hospital  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asbj\u00f8rn Mohr","family":"Drewes","sequence":"additional","affiliation":[{"name":"Mech\u2010Sense, Department of Gastroenterology and Hepatology Aalborg University Hospital  Aalborg Denmark"},{"name":"Department of Clinical Medicine Aalborg University  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhiram","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Wythenshawe Hospital Manchester University NHS Foundation Trust  Manchester UK"},{"name":"Division of Diabetes, Endocrinology &amp; Gastroenterology Faculty of Biology, Medicine and Health The University of Manchester, Manchester Academic Health Sciences Centre  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dipesh H.","family":"Vasant","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Endocrinology &amp; Gastroenterology Faculty of Biology, Medicine and Health The University of Manchester, Manchester Academic Health Sciences Centre  Manchester UK"},{"name":"Neurogastroenterology Unit, Gastroenterology, Wythenshawe Hospital Manchester University NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"McLaughlin","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Endocrinology &amp; Gastroenterology Faculty of Biology, Medicine and Health The University of Manchester, Manchester Academic Health Sciences Centre  Manchester UK"},{"name":"Department of Gastroenterology Northern Care Alliance NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Kiff","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Wythenshawe Hospital Manchester University NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Telford","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Wythenshawe Hospital Manchester University NHS Foundation Trust  Manchester UK"},{"name":"Division of Diabetes, Endocrinology &amp; 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