Faecal incontinence and other defaecatory disorders are commonly assessed using measurement of intraluminal radial pressures in the anorectum during rest and various manoeuvres (“squeeze and push”).

HRAM technology generates colour contour plots of radial pressures throughout anal canal and rectum. Offline data analysis following a protocol of manoeuvres has been developed by Dr Mark Scott (Head of GI Physiology Unit, QMUL) and Ms Emma Carrington (Clinical Research Fellow QMUL) working with MMS.

The basic technology (catheter and hardware) is already marketed internationally for oesophageal and ano-rectal manometry studies; with gradual adoption. The technology novelty lies in the software analysis functions being developed.

This would be a commonly used technique in all major pelvic floor centres and it is increasing worldwide.

Enteric HTC helped the HEI investigators form a technology development partnership with MMS and also Ardmore. Enteric HTC was also linkage partner to the NIHR PGfAR (2014-2018) grant CapaCITY (C.I. Knowles) which embeds 3 phase III RCTs addressing key therapeutic uncertainties in the management of chronic constipation (CC) in adults. All 3 of these trials depended on recruitment of well-defined cohorts of patients with CC. HRAM is a key test in phenotyping these patients (and in one study for stratifying them to treatment allocation). Enteric working with Ardmore has helped facilitate the standardisation of a new automated user friendly protocol of measurements across 15 major UK NHS centres.