Neurophysiology and new techniques to assess esophageal sensory function: an update.
This review aims to discuss the neurophysiology of the esophagus and new methods to assess esophageal nociception. Pain and other symptoms can be caused by diseases in the mucosa or muscular or sphincter dysfunction, together with abnormal pain processing, either in the peripheral or central nervous systems. Therefore, we present new techniques in the assessment of esophageal function and the potential role of the mucosal barrier in the generation and propagation of pain. We discuss the assessment and role of esophageal sphincters in nociception, as well as imaging and electrophysiological techniques, with examples of their use in understanding the sensory system following noxious stimuli to the esophagus. Additionally, we discuss the mechanisms behind functional diseases of the esophagus. We conclude that the new methods have identified many of the mechanisms behind malfunction of the mucosa, disturbances of muscular and sphincter functions, and the central response to different stimuli. Taken together, this has increased our understanding of esophageal disorders and may lead to new treatment modalities.
Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital and Clinical Institute, Aalborg University, Aalborg, Denmark. cb@mech-sense.com.
Christina
C
Brock
Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, Texas.
Richard W
RW
McCallum
Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri.
C Prakash
CP
Gyawali
Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital and Clinical Institute, Aalborg University, Aalborg, Denmark.|Centre for Digestive Diseases, Blizard Institute, Wingate Institute of Neurogastroenterology, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.|Department of Gastroenterology, University Hospitals of North Midlands, Stoke on Trent, United Kingdom.
Adam D
AD
Farmer
Mech-Sense, Department of Radiology, Aalborg University Hospital and Clinical Institute, Aalborg University, Aalborg, Denmark.
Jens Brøndum
JB
Frøkjaer
Department of Medical Physics and Clinical Engineering, Tallaght Hospital and Trinity College, Dublin, Ireland.
Barry P
BP
McMahon
Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital and Clinical Institute, Aalborg University, Aalborg, Denmark.
Asbjørn Mohr
AM
Drewes
D004935:Esophageal Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D000071041:Esophageal Mucosa / Q000502:physiology; D004947:Esophagus / Q000000981:diagnostic imaging / Q000502:physiology*; D059907:Functional Neuroimaging / Q000379:methods; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008365:Manometry / Q000379:methods; D012677:Sensation / Q000502:physiology*
brain; esophagus; gastroesophageal reflux disease; pain; sphincter