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Am J Physiol Gastrointest Liver Physiol 284: G461-G471, 2003. First published November 13, 2002; doi:10.1152/ajpgi.00456.2001
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Vol. 284, Issue 3, G461-G471, March 2003

Sensory and biomechanical responses to ramp-controlled distension of the human duodenum

Chunwen Gao1,3, Lars Arendt-Nielsen1, Weiming Liu1, Poul Petersen2, Asbjørn Mohr Drewes1,2, and Hans Gregersen1,3

1 Center for Sensory-Motor Interaction, Aalborg University; and Departments of 2 Medical Gastroenterology and 3 Surgical Gastroenterology, Aalborg Hospital, Aalborg, Denmark

The aim of this study was to develop a new method for investigation of the relationship among the mechanical stimulus, the biomechanical properties, and the visceral perception evoked by volume/ramp-controlled distension in the human duodenum in vivo. An impedance planimetric probe for balloon distension was placed in the third part of the duodenum in seven healthy volunteers. Distension of the duodenum was done at infusion rates of 10, 25, and 50 ml/min. The pump was reversed when level 7 was reached on a visual analog scale ranging from 0 to 10. Distensions were done with and without the administration of the antimuscarinic drug butylscopolamine. The total circumferential tension (Ttotal) and the passive circumferential tension (Tpassive) were determined from the distension tests without and with the administration of butylscopolamine, respectively. Ttotal and Tpassive showed an exponential behavior as a function of strain (a measure of deformation). The active circumferential tension (Tactive) was computed as Ttotal-Tpassive and showed a bell-shaped behavior as a function of strain. At low distension intensities, the intensity of sensation at 10 ml/min was significantly higher than that obtained at 25 and 50 ml/min. The coefficient of variation at the pain threshold for circumferential strain (average 4.34) was closer to zero compared with those for volume (8.72), pressure (31.22), and circumferential tension (31.55). This suggests that the mechanoreceptors in the gastrointestinal wall depend primarily on circumferential strain. The stimulus-response functions provided evidence for the existence of low- and high-threshold mechanoreceptors in the human duodenum. Furthermore, the data suggest that high-threshold receptors are nonadapting.

cross-sectional area; distensibility; duodenum; pain; length-tension relationship


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H. Gregersen, T. Hausken, J. Yang, S. Odegaard, and O. H. Gilja
Mechanosensory properties in the human gastric antrum evaluated using B-mode ultrasonography during volume-controlled antral distension
Am J Physiol Gastrointest Liver Physiol, May 1, 2006; 290(5): G876 - G882.
[Abstract] [Full Text] [PDF]




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