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Am J Physiol Gastrointest Liver Physiol (March 6, 2002). doi:10.1152/ajpgi.00496.2001
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Articles in PresS, published online ahead of print March 6, 2002
Am J Physiol Gastrointest Liver Physiol, 10.1152/ajpgi.00496.2001
Submitted on November 19, 2001
Accepted on January 29, 2002

MULTI-MODAL ASSESSMENT OF PAIN IN THE ESOPHAGUS - A NEW EXPERIMENTAL MODEL

Asbjorn M Drewes1*, Klaus-Peter Schipper2, Georg Dimcevski2, Poul Petersen2, Ole Kaeseler Andersen3, Hans Gregersen3, and Lars Arendt-Nielsen3

1 Department of Medical Gastroenterology, Aalborg Hospital, Aalborg, Denmark; Center for Sensory-Moto Interactions, Aalborg University, Aalborg, Denmark
2 Department of Medical Gastroenterology, Aalborg Hospital, Aalborg, Denmark
3 Center for Sensory-Moto Interactions, Aalborg University, Aalborg, Denmark

* To whom correspondence should be addressed. E-mail: drewes{at}smi.auc.dk.

A new multi-modal pain assessment model was developed integrating electrical, mechanical, cold and warmth stimuli into the same device. The device with a bag and electrodes for electrical stimulation was positioned in the lower part of the esophagus in eleven healthy subjects. Mechanical stimuli were delivered with an impedance planimetric system. Thermal stimuli were performed by circulating water of different temperatures (5-50 degrees of Celsius) inside the bag. All subjects reported both non-painful and painful local and referred sensations to all stimuli. Temporal summation could be studied to repeated electrical stimuli. For all stimuli there was a relationship between stimulus intensity and pain intensity. The referred pain area increased with increasing intensity of the electrical and mechanical stimuli. There were several differences between the sensations evoked by the four stimulus modalities indicating activation of different visceral nerve pathways. The model offers the possibility for controlled multi-modal stimuli activating the superficial and deeper layers of the human gut and should be used in basic, clinical and pharmacological pain studies.




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