ALIMENTARY TRACT: Clinical ReviewClinical Utility of Colonic and Anorectal Manometry in Chronic ConstipationRao, Satish S.C. MD, PhD, FRCP (Lon); Singh, Siddharth MDAuthor Information Division of Gastroenterology/Hepatology, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa Declaration of Funding Source: None. Reprints: Satish S.C. Rao, MD, PhD, FRCP (Lon), Division of Gastroenterology/Hepatology, Department of Internal Medicine, University of Iowa Hospitals and Clinics, 4612 JCP, Iowa City, Iowa 52242 (e-mail: Satishemail@example.com). Conflict of Interest: None. Journal of Clinical Gastroenterology: October 2010 - Volume 44 - Issue 9 - p 597-609 doi: 10.1097/MCG.0b013e3181e88532 Buy SDC Metrics Abstract Constipation is one of the most common digestive problems in North America with significant psychosocioeconomic implications. It is caused by either a primary disorder of colonic and anorectal function or by many secondary conditions such as constipating drugs, metabolic disorders and other colorectal problems. Given the heterogeneity of problems that cause constipation, defining the underlying pathophysiology is increasingly being recognized as a key step toward optimal management. Colonic manometry with sensation and tone assessment (barostat) and anorectal manometry with rectal sensation and compliance assessment and balloon expulsion test can provide a comprehensive evaluation of colonic and anorectal sensorimotor function and facilitate a diagnosis of slow transit constipation, dyssynergic defecation or irritable bowel syndrome, or an overlap of these disorders. This review provides a critical appraisal of the role of manometric techniques toward augmenting our understanding of colonic and anorectal physiology, both in health and constipation and discussing their clinical utility in the diagnosis and management of chronic constipation. Copyright © 2010 Wolters Kluwer Health, Inc. All rights reserved.