Document Detail

Symptom hypersensitivity to acid infusion is associated with hypersensitivity of esophageal contractility.
MedLine Citation:
PMID:  14977636     Owner:  NLM     Status:  MEDLINE    
Several investigators have observed that repeated acid infusions induce stronger symptoms (symptom hypersensitivity). The goal of our study was to determine whether symptom hypersensitivity is associated with esophageal contractile hypersensitivity. Subjects with chronic heartburn symptoms underwent simultaneous pressure and ultrasound imaging of esophagus. Normal saline and 0.1 N HCl were sequentially infused into the esophagus, and subjects scored heartburn symptoms on a 1-10 scale. Saline and HCl infusions were repeated in 10 subjects with a positive Bernstein test. Esophageal contraction amplitude and duration and muscularis propria thickness were measured using a computerized method during recording. Acid infusion induced heartburn. Esophageal contractions had higher amplitudes (pressure 114.2 +/- 7.0%) and longer duration (116.8 +/- 4.4%) during acid infusion compared with saline infusion. Average muscle thickness was greater during acid infusion than saline infusion (107.0 +/- 2.0%). Sustained esophageal contractions (SECs) were identified during acid infusion. A second acid infusion (acid-2) induced heartburn with shorter latency (93.0 +/- 15.0 vs. 317.0 +/- 43.0 s) and stronger severity (8.5 +/- 0.5 vs. 5.3 +/- 0.8) than the first acid infusion (acid-1). Contraction amplitudes (140.2 +/- 13.0%), average muscle thickness (118.0 +/- 3.3%), and contraction duration (148.5 +/- 5.6 vs. 116.8 +/- 4.4%) were higher during acid-2 than acid-1. Also, numbers of SECs were greater during acid-2 than acid-1 (31 in 8 subjects vs. 11 in 6 subjects). Our data show that acid infusion into esophagus induces esophageal hypersensitivity and that a close temporal correlation exists between symptom hypersensitivity and contractility hypersensitivity.
Vikas Bhalla; Jianmin Liu; James L Puckett; Ravinder K Mittal
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.     Date:  2004-02-19
Journal Detail:
Title:  American journal of physiology. Gastrointestinal and liver physiology     Volume:  287     ISSN:  0193-1857     ISO Abbreviation:  Am. J. Physiol. Gastrointest. Liver Physiol.     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-06-14     Completed Date:  2004-07-23     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  100901227     Medline TA:  Am J Physiol Gastrointest Liver Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  G65-71     Citation Subset:  IM    
Section of Gastroenterology 111D, University of California-San Diego, 3350 La Jolla Village Drive, San Diego, CA 92161, USA.
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MeSH Terms
Esophageal Diseases / diagnosis,  etiology*,  pathology,  physiopathology*
Esophagus / pathology,  physiopathology*
Heartburn / chemically induced,  complications*,  physiopathology*
Hydrochloric Acid
Middle Aged
Time Factors
Grant Support
Reg. No./Substance:
7647-01-0/Hydrochloric Acid

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