Cerebral electrical potentials evoked by balloon distention of the human esophagus

Castell, Donald O.; Wood, Jackie D.; Frieling, Thomas; Wright, Francis S.; Vieth, Robert F.

doi:10.1016/0016-5085(90)90286-a

Cited by 60 publications

(32 citation statements)

References 13 publications

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“…Eight healthy subjects, three women and five men (median age 24 years, range [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38], all of whom received remuneration for their participation, were studied. No subject had a history of gastrointestinal or other intercurrent illness, oesophageal symptoms or sleep disturbances and none was receiving any treatment.…”

Section: Methods and Subjects Subjects And Study Protocolmentioning

confidence: 99%

Nocturnal oesophageal motor activity is dependent on sleep stage.

Castiglione¹,

Emde²,

Armstrong³

et al. 1993

Gut

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Simultaneous overnight oesophageal pH and manometric and sleep electroencephalographic recordings were performed in eight healthy subjects, aged 20-38 years, to test the hypothesis that the frequency of primary, swallow related contractions decreases progressively with deeper sleep stages whereas the frequency of secondary contractions remains constant throughout the night. During the nocturnal period (2300 to 0700), periods of oesophageal motor quiescence were interspersed by clusters of contractions detected 5 and 15 cm above the lower oesophageal sphincter. Primary contractions decreased in frequency from 142/min (median) during arousal periods to 0.22/min during stage 1 sleep, 0-05/min during stages 2 to 4 combined, and 0-03/min during rapid eye movement (REM) sleep. Secondary contractions were also most frequent during arousal periods (0-51/min) and they, too, decreased in frequency during stage 1 (0.35/min) and stages 2 to 4 combined (0-08/min). During REM sleep, however, the frequency of secondary contractions increased (0.50/min) to levels noted during arousal and stage 1 sleep. Compared with primary contractions, secondary contractions had a lower amplitude (51.9 hPa v 76-0 hPa; p=00078) and a shorter duration (3.08 v 4-06 s; p=00078). The results of this study suggest that there is no intrinsic oesophageal motor activity in the absence of a stimulatory input from the central nervous system and that the increased number of secondary contractions during REM sleep may be a result of an REM related increase in autonomic nervous system activity although a temporary decrease of efferent inhibitory influences cannot be ruled out. Nocturnal contraction clusters comprise both primary contractions during arousals and stage 1 sleep and secondary contractions during REM sleep.

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Section: Methods and Subjects Subjects And Study Protocolmentioning

confidence: 99%

Nocturnal oesophageal motor activity is dependent on sleep stage.

Castiglione¹,

Emde²,

Armstrong³

et al. 1993

Gut

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show abstract

“…Additional factors that may influence patient response to mechanical stimulation include age [26,27] and gender [28]; younger subjects and females are more sensitive [29]. However, no gender differences have been found in esophageal evoked potential characteristics [26,30]. The commercial availability of a standardized balloon catheter and air inflation pump, providing a uniform inflation rate, has made it much more feasible to compare results among laboratories.…”

Section: Esophageal Mechanical Sensitivitymentioning

confidence: 99%

Esophageal sensitivity and symptom perception in gastroesophageal reflux disease

Shi

Tatum

Joehl

et al. 1999

Curr Gastroenterol Rep

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Patients with gastroesophageal reflux disease (GERD) experience a wide spectrum of symptoms, varying both in quality and severity. This review summarizes clinical observations of esophageal sensitivity and symptom perception in GERD patients. The Bernstein test, although lacking standardization, remains a useful tool in determining esophageal sensitivity to acid stimuli. Ambulatory 24-hour pH monitoring with symptom event marking and subsequent symptom-reflux correlation between acid reflux events and esophageal symptomatology now provides an alternative method for establishing esophageal acid sensitivity. The intraesophageal balloon distention test (IEBD) was developed to assess esophageal sensitivity to mechanical stimuli. Variants of each of these tests have been applied to the evaluation of uncomplicated GERD patients and patients with esophagitis and Barrett's metaplasia, who generally demonstrate less esophageal sensitivity than the former group. Studies using these methods have demonstrated increased esophageal sensitivity in patients with esophageal chest pain and have also identified a subset of patients with esophageal symptoms yet normal esophageal acid exposure, a condition referred to as "hypersensitive esophagus." The Bernstein test, 24-hour pH monitoring with symptom assessment, and IEBD have each contributed to our understanding of esophageal pain syndromes; it is hoped that future work in this area will lead to improved and more specific therapy for these patients.

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“…Considerable insight has been acquired however. Investigations into the effect of luminal content [8,9], esophageal distention [9][10][11] and muscular function [12], and neural pathways and brain localization [13,14] have provided a basic understanding of the stimuli responsible for symptom generation. It also is clear that the visceroneural pathways of the foregut are complexly intertwined with that of the tracheobronchial tree and heart.…”

Section: Mechanisms Of Esophageal Symptomsmentioning

confidence: 99%

The importance of symptom assessment in the surgical treatment of gastroesophageal reflux disease and Barrett’s esophagus

Peters

2006

Surg Endosc

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The "art" and science of symptom assessment in the evaluation of patients with gastroesophageal reflux disease has been under emphasized. In fact, it is critical to judgements regarding surgical versus non-surgical therapy and is much more difficult than meets the eye. Many symptoms thought to be secondary to gastroesophageal reflux are not, and some, such as asthma cough and chest pain, which are commonly thought secondary to other causes, are indeed symptoms of reflux. Diagnostic studies are helpful but far from perfect, ultimately requiring the clinician's expert judgement as the key factor in determining a successful outcome. The following outlines both an approach to the assessment of symptoms and when possible, clinical studies shedding light on their cause and interpretation.

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Cerebral electrical potentials evoked by balloon distention of the human esophagus

Cited by 60 publications

References 13 publications

Nocturnal oesophageal motor activity is dependent on sleep stage.

Nocturnal oesophageal motor activity is dependent on sleep stage.

Esophageal sensitivity and symptom perception in gastroesophageal reflux disease

The importance of symptom assessment in the surgical treatment of gastroesophageal reflux disease and Barrett’s esophagus

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