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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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