Studies using graded intra-esophageal balloon distention. Lasch, Hugh, Donald O. Castell, June A. Castell. Jefferson Medical College and The Graduate Hospital, Philadelphia, PA
APStracts 3:0180G, 1996.
Graded intra-esophageal balloon distention (IEBD) has been utilized in the past to evaluate esophageal pain thresholds. Using a technique which we have found to provide reproducible results for pain thresholds, two groups of normal individuals without esophageal symptoms or diabetes were studied. Group I included 10 "young" (age < 65) individuals (mean age 27, range 18-57). Group II included 17 individuals age 65 or greater (mean age 72.5, range 65 to 87). Catheters with latex balloons (Wilson-Cook) were used in all 27 subjects with the balloon located 10 cm above the lower esophageal sphincter (LES). Sequential inflations of 2 cc increments were performed until a total volume of 2 cc above the point of pain or to a maximum of 30 cc was reached. A series of 2 sequential inflations were performed on each subject on the day of the testing and the mean value was taken to indicate pain threshold volumes for all 27 subjects. In the group of elderly volunteers, 5 subjects felt no pain even at the maximum inflatable volume of the balloon (30 ccs) and were assigned a maximum threshold value of 30 ml. Mean pain threshold volumes for the young subjects was 17 +/- 0.8 cc of air (+/- S.E.) and for the elderly subjects was 27 +/- 1.4 cc (p<0.01 and 95% confidence = 7.1 to 13.3). Conclusion: IEBD results in the esophagus indicate an age-related decrease in human visceral pain threshold.

Received 30 July 1996; accepted in final form 26 August 1996.
APS Manuscript Number G303-6.
Article publication pending Am. J. Physiol. (Gastrointest. Liver
Physiology).
ISSN 1080-4757 Copyright 1996 The American Physiological Society.
Published in APStracts on 7 October 1996