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Am J Physiol Gastrointest Liver Physiol 283: G95-G103, 2002. First published March 6, 2002; doi:10.1152/ajpgi.00496.2001
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Vol. 283, Issue 1, G95-G103, July 2002

Multimodal assessment of pain in the esophagus: a new experimental model

Asbjørn Mohr Drewes1,2, Klaus-Peter Schipper1, Georg Dimcevski1, Poul Petersen1, Ole Kæseler Andersen2, Hans Gregersen2,3, and Lars Arendt-Nielsen2

1 Department of Medical Gastroenterology, Aalborg Hospital 9000; 2 Laboratory for Experimental Pain Research, Center for Sensory-Motor Interactions, Aalborg University 9120; and 3 Department of Surgical Gastroenterology, Aalborg Hospital, 9000 Aalborg, Denmark

A new multimodal 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 11 healthy subjects. Mechanical stimuli were delivered with an impedance planimetric system. Thermal stimuli were performed by circulating water of different temperatures (5-50°C) inside the bag. All subjects reported both nonpainful and painful local and referred sensations to all stimuli. Temporal summation to repeated electrical stimuli could be studied. 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. This model offers the possibility for controlled multimodal stimuli activating the superficial and deeper layers of the human gut and should be used in basic, clinical, and pharmacological pain studies.

experimental pain; gastrointestinal pain; gut; electrical stimuli; mechanical stimuli; thermal stimuli





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