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

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...

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Bibliographic Details
Published in:American journal of physiology: Gastrointestinal and liver physiology 2002-07, Vol.283 (1), p.G95-G103
Main Authors: Drewes, Asbjørn Mohr, Schipper, Klaus-Peter, Dimcevski, Georg, Petersen, Poul, Andersen, Ole Kaeseler, Gregersen, Hans, Arendt-Nielsen, Lars
Format: Article
Language:English
Subjects:
Adult
Catheterization
Electric Stimulation
Esophagus - physiopathology
Female
Hot Temperature
Humans
Male
Middle Aged
Pain - physiopathology
Physical Stimulation
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Summary: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 degrees 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.
ISSN:0193-1857
1522-1547
DOI:10.1152/ajpgi.00496.2001