Document Detail


Diminished mechanosensitivity and chemosensitivity in patients with achalasia.
MedLine Citation:
PMID:  14613920     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Stephen Brackbill; Guoxiang Shi; Ikuo Hirano
Publication Detail:
Type:  Journal Article    
Journal Detail:
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:
Created Date:  2003-11-17     Completed Date:  2004-01-08     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  100901227     Medline TA:  Am J Physiol Gastrointest Liver Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  G1198-203     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology, Northwestern University Medical School, Chicago, Illinois 60611, USA.
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MeSH Terms
Descriptor/Qualifier:
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:
7647-01-0/Hydrochloric Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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