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Am J Physiol Gastrointest Liver Physiol 282: G683-G689, 2002. First published December 5, 2001; doi:10.1152/ajpgi.00134.2001
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Vol. 282, Issue 4, G683-G689, April 2002

Identification of the biomechanical factors associated with the perception of distension in the human esophagus

J. D. Barlow1, H. Gregersen2, and D. G. Thompson1

1 Gastrointestinal Science Group, University of Manchester, Hope Hospital, Salford M6 8HD, United Kingdom; and 2 Center for Sensory-Motor Interaction, Department of Surgery A, Aalborg Hospital, Aalborg University, Aalborg DK-9220, Denmark

Current techniques used to investigate the mechanisms responsible for the sensory responses to distension of the human esophagus provide limited information because the degree of circumferential stretch required to determine tension can only be inferred. We used impedance planimetry to measure the cross-sectional area during esophageal distension to ascertain the degree of stretch and tension that initiated motor and sensory responses. Hyoscine-N-butyl bromide (HBB), a cholinergic muscarinic receptor blocker, was also used to alter esophageal tension during distension. Motor activity was initiated at a lower degree of stretch and tension than that which initiated sensory awareness; both increased directly with increasing distension. HBB reduced both esophageal motility and tension during distension without altering the relationship between sensation intensity and cross-sectional area. Esophageal stretch, rather than tension, thus appears to be the major factor influencing sensory responses to esophageal distension.

impedance planimetry; cross-sectional area; tension; esophageal motor activity; esophageal sensation


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