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 reference		Gender; (fem)	Age; (y)	BET (simulated stool, volume (mL), body position, time (min))	Comparative test (used criteria)	Se	Sp	PPV	NPV
[39]	61	61	50	W 50 S 2	HRM and/or DEF pr-pc or pr-nr, ce-i	33	80	71	45
[34]	236	264	44	W 50 S 2	ARM pr-pc or pr-nr	85	71	77	80
[11]	100	80	53	W 50 S 3	ARM pr-pc	60	1	100	52
[5]	52	49	35	W 50 S 5	ARM pr-pc or pr-nr	94	75	89	86
[40]	295	295	48	W 50 S 3	HRM pr-pc or pr-nr	29	78	39	70
[41]	132	256	52	A 50 S 2	ARM pr-pc or pr-nr	76	92	92	80
[33]	130	124	38	W SD S 1	ARM + DEF pr-pc or pr-nr, ce-i	88	89	64	97
[42]	46	34	46	A 20 S	DEF ce-i	41	92	82	63
[43]	134	112	52	W 60 S	DEF ce-i or ce-f	37	88	71	64
[45]	74	65		W 10	DEF ce-i or ce-f	87	63	51	91
[14]	32		46	W 50	EMG i	75	88	95	54
[35]	35	30	44	W 50 S 5	ARM + DEF/CTT pr-pc or pr-nr, ce-i, stt	89	76	80	87
[13]	123	118	51	A 60 S 5	DEF ce-i	52	58	57	54

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).