| Diminished mechanosensitivity and chemosensitivity in patients with achalasia. | |
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MedLine Citation:
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PMID: 14613920 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The pathogenesis of achalasia involves the degeneration of enteric and autonomic nervous systems with resultant effects on esophageal motility. The neural degeneration could affect visceral sensation in achalasia. The aim of this study was to examine mechanosensitivity and chemosensitivity in patients with achalasia. Perceptual responses to esophageal distension and acid perfusion were assessed in nine achalasia patients and nine healthy subjects. Mechanosensitivity was evaluated using a barostat with a double-random staircase distension protocol. Responses were graded as follows: 0, no sensation; 1, initial sensation; 2, mild discomfort; 3, moderate discomfort; and 4, pain. Chemosensitivity was graded along a visual analog scale after perfusion of saline and 0.1 N HCl. Barostat pressure-volume relationships were used to report esophageal body compliance. Barostat pressures for initial sensation and mild discomfort were not significantly different for patients and controls. The pressures for moderate discomfort (37.9 +/- 3.5 vs. 25.7 +/- 2.4 mmHg; P < 0.05) and pain (47.8 +/- 2.3 vs. 32.2 +/- 3.5 mmHg; P = 0.002) were significantly higher in achalasics than controls. Seven of the eight achalasia patients never reached pain thresholds at the maximum distension pressure (50 mmHg). Sensation to acid perfusion was significantly lower in achalasics compared with controls (2.2 +/- 1.2 vs. 6.7 +/- 1.7 cm; P < 0.05). Compliance was significantly increased in patients with achalasia compared with controls. We conclude that both mechanosensitivity and chemosensitivity are significantly diminished in achalasia patients compared with controls. Also, initial sensation and pain sensation are differentially affected in achalasics. These findings suggest that neuropathic defects in achalasia may manifest themselves in visceral sensory and motor dysfunction. |
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Authors:
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Stephen Brackbill; Guoxiang Shi; Ikuo Hirano |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American journal of physiology. Gastrointestinal and liver physiology Volume: 285 ISSN: 0193-1857 ISO Abbreviation: Am. J. Physiol. Gastrointest. Liver Physiol. Publication Date: 2003 Dec |
Date Detail:
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Created Date: 2003-11-17 Completed Date: 2004-01-08 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 100901227 Medline TA: Am J Physiol Gastrointest Liver Physiol Country: United States |
Other Details:
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Languages: eng Pagination: G1198-203 Citation Subset: IM |
Affiliation:
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Division of Gastroenterology, Northwestern University Medical School, Chicago, Illinois 60611, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Case-Control Studies Chemoreceptor Cells / physiopathology* Compliance Esophageal Achalasia / physiopathology* Esophagus / physiopathology Female Humans Hydrochloric Acid / administration & dosage Male Mechanoreceptors / physiopathology* Middle Aged Muscle Contraction Muscle, Smooth / physiopathology Perfusion Pressure |
| Chemical | |
Reg. No./Substance:
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7647-01-0/Hydrochloric Acid |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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