Digestive Diseases and Sciences

, Volume 38, Issue 2, pp 206–212 | Cite as

Altered esophageal pain threshold in irritable bowel syndrome

  • Mario Costantini
  • Giacomo Carlo Sturniolo
  • Giovanni Zaninotto
  • Renata D'Incà
  • Rita Polo
  • Remo Naccarato
  • Ermanno Ancona
Original Articles


Gut motility disorders and altered pain perception were reported in patients with irritable bowel syndrome (IBS). To verify foregut involvement in IBS, we studied 30 patients using esophageal manometry and 24-hr pH monitoring of the distal esophagus. Two subgroups of patients underwent esophageal provocative tests (bethanechol 50 μg/kg subcutaneously and esophageal balloon distension test). Twelve healthy volunteers formed a control group. A pain threshold on esophageal distension significantly lower than in healthy subjects (11.5±1 ml vs 22.2±1.7 ml,P<0.01) was found in IBS patients. On the other hand, no differences between patients and controls were detected in lower esophageal sphincter pressure and length, esophageal body motility, or GER pattern; furthermore, bethanechol stimulation elicited similar esophageal body motility changes. Our study could confirm no detectable basal or bethanechol-induced esophageal motility disorders in IBS patients, nor enhanced GER. Esophageal involvement in IBS consists of a lower pain threshold on esophageal distension, possibly reflecting an altered visceral receptor sensitivity or modulation throughout the gut.

Key Words

irritable bowel syndrome esophageal motility gastroesophageal reflux esophageal provocative testing balloon distension test 24-hr pH monitoring 


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Copyright information

© Plenum Publishing Corporation 1993

Authors and Affiliations

  • Mario Costantini
    • 1
    • 2
  • Giacomo Carlo Sturniolo
    • 1
    • 2
  • Giovanni Zaninotto
    • 1
    • 2
  • Renata D'Incà
    • 1
    • 2
  • Rita Polo
    • 1
    • 2
  • Remo Naccarato
    • 1
    • 2
  • Ermanno Ancona
    • 1
    • 2
  1. 1.Department of Surgery (Chirurgia Generale 2)Università di PadovaPadovaItaly
  2. 2.Division of GastroenterologyUniversity of PaduaPaduaItaly

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