title: Mechanosensation and mucosal blood perfusion in the esophagus of healthy volunteers studied with a multimodal device incorporating laser Doppler flowmetry and endosonography.
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.
authors.affiliation: Institute of Medicine, University of Bergen, Bergen, Norway. dag.hoff@helse-bergen.no
authors.forename: Dag Arne Lihaug
authors.initials: DA
authors.lastname: Hoff
authors.forename: Hans
authors.initials: H
authors.lastname: Gregersen
authors.forename: Svein
authors.initials: S
authors.lastname: Odegaard
authors.forename: Donghua
authors.initials: D
authors.lastname: Liao
authors.forename: Jan Gunnar
authors.initials: JG
authors.lastname: Hatlebakk
mesh_terms: D000328:Adult; D000368:Aged; D002404:Catheterization / Q000295:instrumentation; D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology; D003937:Diagnosis, Differential; D019160:Endosonography / Q000295:instrumentation*; D004867:Equipment Design; D004947:Esophagus / Q000098:blood supply / Q000000981:diagnostic imaging / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa / Q000098:blood supply* / Q000000981:diagnostic imaging; D017078:Laser-Doppler Flowmetry / Q000295:instrumentation*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011312:Pressure; D012016:Reference Values; D012039:Regional Blood Flow / Q000502:physiology*; D055815:Young Adult