Evacuation Problems? Check the RED Test

Evacuation Problems? Check the RED Test

Douglas K. Rex, MD, MASGE, reviewing Chey WD, et al. Clin Gastroenterol Hepatol 2021 Dec 1.

The balloon expulsion test (BET) is a screening tool for rectal evacuation disorders. BET is often performed in conjunction with anorectal manometry. In this report, investigators described a device they developed called the Rectal Expulsion Device (RED), an office-based, point-of-care device that, like BET, can be used to screen for rectal evacuation disorders. With RED, the device is inserted rectally and a cap on the external portion of the device is removed to automatically inflate a balloon at the end of the inserted portion of the device. The patient then attempts expulsion. An abnormal test is retention of the device for ≥60 seconds. 

In a study that included 20 patients with functional constipation and 5 healthy volunteers, all 5 healthy participants expelled the BET and RED devices within 60 seconds each. In comparison, 8 of the 20 patients with functional constipation expelled the BET device within 60 seconds, and 9 of 20 expelled the RED device within 60 seconds.

Douglas K. Rex, MD, FASGE


We’ll need some bigger studies of this device, but certainly, a simple, reliable point-of-care test for evacuation disorder is needed.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.


Chey WD, Baker J, Watts L, Harris A, Shah E. Development of a simple, point-of-care device to test anorectal function in patients with constipation: randomized clinical trial. Clin Gastroenterol Hepatol 2021 Dec 1. (Epub ahead of print) (https://doi.org/10.1016/j.cgh.2021.11.034)

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