{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T22:44:56Z","timestamp":1784241896922,"version":"3.55.0"},"reference-count":19,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:00:00Z","timestamp":1745452800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Currently, high\u2010resolution anorectal manometry (HRAM) is the only way to confirm the diagnosis of defecatory dyssynergia; however, it has limitations in pediatric patients. Digital rectal examination (DRE) may suggest the presence of defecatory dyssynergia based on clinical findings, but it is not a definitive diagnostic method. Its role in pediatric patients remains unexplored. The objective of this study was to determine the usefulness of DRE as a diagnostic test for dyssynergic defecation in pediatric patients compared with HRAM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients aged 5\u201318\u2009years who were referred for HRAM in a third\u2010level hospital in Mexico City between March 2022 and September 2022 were included. Altered propulsion or impaired push effort was considered a suggestive diagnosis of dyssynergia by DRE. The results were compared with those obtained using HRAM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010two patients were included, of whom 50% were male, with a median age of 10.68\u2009years (standard deviation [SD] 3.23). Dyssynergia was diagnosed by DRE in 21 patients (50%) and by HRAM in 21 patients (50%). A sensitivity of 66% and a specificity of 66% were calculated for the alteration of rectal propulsion in DRE as suggestive of dyssynergia when compared to HRAM. A positive predictive value of 66% and a negative predictive value of 66% were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Inferences<\/jats:title><jats:p>The sensitivity and specificity of DRE for the diagnosis of dyssynergic defecation were lower than those reported for adults (75% and 85%, respectively). In some cases, DRE would be useful, especially in low\u2010resource scenarios where HRAM is not available, and we recommend DRE prior to HRAM as a complementary approach to dyssynergic defecation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.70061","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T14:40:05Z","timestamp":1745505605000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Use of Digital Rectal Exam Compared With High\u2010Resolution Anorectal Manometry in the Diagnosis of Dyssynergic Defecation in Pediatrics"],"prefix":"10.1111","volume":"37","author":[{"given":"Carolina Alexandra Zambrano","family":"P\u00e9rez","sequence":"first","affiliation":[{"name":"Gastroenterology and Nutrition Department Instituto Nacional de Pediatr\u00eda  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8701-4189","authenticated-orcid":false,"given":"Erick Manuel","family":"Toro\u2010Monjaraz","sequence":"additional","affiliation":[{"name":"Gastroenterology and Nutrition Department Instituto Nacional de Pediatr\u00eda  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0936-4807","authenticated-orcid":false,"given":"Samuel","family":"Nurko","sequence":"additional","affiliation":[{"name":"Center for Motility and Functional Gastrointestinal Disorders Boston Children\u00b4s Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"P\u00e9rez\u2010Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Experimental Oncology Division Instituto Nacional de Pediatria  Mexico City 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Pediatr\u00eda  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ericka","family":"Montijo Barrios","sequence":"additional","affiliation":[{"name":"Gastroenterology and Nutrition Department Instituto Nacional de Pediatr\u00eda  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flora","family":"Z\u00e1rate\u2010Mondrag\u00f3n","sequence":"additional","affiliation":[{"name":"Gastroenterology and Nutrition Department Instituto Nacional de Pediatr\u00eda  Mexico City 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