Abstract
Both mechanical and ischemic mechanisms can cause gastrointestinal pain. We investigated whether discomfort and pain caused by bag distension in the esophagus of healthy subjects correlated best with mechanical forces (stress), deformation (strain), or mucosal perfusion. Twenty-nine subjects underwent ramp bag distension using a novel catheter design incorporating high-frequency intraluminal ultrasound, laser Doppler flowmetry, and manometry. Perfusion, pressure, and geometric data were analyzed at visual analog scale (VAS) levels 1–7 in 19 subjects. The circumferential stress increased exponentially as a function of volume, whereas strain showed a linear increase. The perfusion showed a modest decline, on average 15% from baseline to VAS = 7. A significant association was found between the sensory response and stress and strain (P < 0.05). No significant association was found between the sensory response and perfusion. In conclusion, the discomfort and pain response to bag distension in the esophagus is likely to be caused by mechanical rather than ischemic mechanisms.
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Abbreviations
- BSB:
-
Butylscopolamine bromide
- LDF:
-
Laser Doppler flowmetry
- PU:
-
Perfusion unit
- CSA:
-
Cross-sectional area
- VAS:
-
Visual analog scale
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Acknowledgments
We acknowledge Helse Vest RHF and Helse Sunnmøre HF for sponsorship. We would like to thank Sunniva Stiansen and Eva Fosse for their patient assistance during each investigation and Kjell and Bjørn Bakken at Perimed AB for kindly answering questions regarding the laser Doppler flowmetry. We are also grateful to Goerill Skaale Johansen at the Department of Photo and Illustration, University of Bergen, and Maria Sibbel at MGS Studio, Ames, USA, for their kind and professional help with the illustrations in this paper.
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Hoff, D.A.L., Gregersen, H., Odegaard, S. et al. Mechanosensation and Mucosal Blood Perfusion in the Esophagus of Healthy Volunteers Studied with a Multimodal Device Incorporating Laser Doppler Flowmetry and Endosonography. Dig Dis Sci 55, 312–320 (2010). https://doi.org/10.1007/s10620-009-0731-6
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DOI: https://doi.org/10.1007/s10620-009-0731-6