Role of upper esophageal reflex and belch reflex dysfunctions in noncardiac chest pain.
Fifty-four patients examined for noncardiac chest pain (NCCP), showing no esophageal motor disorder or gastroesophageal reflux disease compatible with NCCP, were subjected to an intraesophageal balloon distension test and a study of the belching reflex provoked by intraesophageal air injection. Thirty-three control subjects were also studied, allowing us to define high-threshold belchers (group I) as those who belched during two of three 40-ml distensions and low-threshold belchers (group II) as those who did not. The balloon distension test induced NCCP in 64% of the patients in group I, and in 14% of the patients in group II (P < 0.01). High-threshold belching was a factor favoring the positivity of the balloon distension test. This result supports the hypothesis that esophageal distension by air due to a belching disorder may be the mechanism responsible for NCCP in some patients with an abnormal sensitivity to balloon distension.
Gignoux
C
C
Service de Gastroentérologie et d'Hépatologie, Hôpital A. Michallon, Grenoble, France.
Bost
R
R
Hostein
J
J
Turberg
Y
Y
Denis
P
P
Cohard
M
M
Wolf
J E
JE
Fournet
J
J
D000388:Air; D002404:Catheterization; D002637:Chest Pain / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D004884:Eructation / Q000503:physiopathology*; D004947:Esophagus / Q000294:innervation* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011446:Prospective Studies; D012021:Reflex, Abnormal / Q000502:physiology*