Visceral Pain Model, Esophageal Pain
Synonyms
Esophageal Pain, Non-Cardiac Chest Pain; gastroesophageal reflux disease; Central Hyperexcitability; Visceral Hyperalgesia
Definition
Recurrent chest pain without demonstrable cardiac abnormalities is often referred to as non-cardiac chest pain (NCCP). In many cases, such pain can originate from the esophagus as a result of gastroesophageal reflux disease (GERD) or motor dysfunction of the esophagus. Pain which results from abnormal sensory perception in the esophagus, known as “functional” pain, can also result in NCCP, and is characterized as pain in the absence of biochemical, endoscopic, histologic or manometric abnormalities.
Characteristics
Non-cardiac chest pain (NCCP) is most often presumed to be of esophageal origin, and is characterized by episodes of unexplained pain that are usually localized in the mid-sternal region, and may often radiate to the back, neck, jaw and arms. Pain of esophageal origin can be easily confused with that of cardiac angina, since there...
References
- 1.Drewes AM, Schipper K-P, Dimcevski G, Petersen P, Andersen OK, Gregersen H, Nielsen LA (2002) Multimodal Assessment of Pain in the Esophagus: A New Experimental Model. Am J Physiol 283:G95–G103Google Scholar
- 2.Drewes AM, Schipper K-P, Dimcevski G, Petersen P, Andersen OK, Gregersen H, Nielsen LA (2003) Multi-Modal Induction and Assessment of Allodynia and Hyperalgesia in the Human Esophagus. Eur J Pain 7:539–549Google Scholar
- 3.Euchner-Wamser I, Meller ST, Gebhart GF (1994) A Model of Cardiac Nociception in Chronically Instrumented Rats: Behavioral and Electrophysiological Effects of Pericardial Administration of Algogenic Substances. Pain 58:117–128Google Scholar
- 4.Garrison DW, Chandler MJ, Foreman RD (1992) Viscerosomatic Convergence onto Feline Neurons from Esophagus, Heart and Somatic Fields: Effects of Inflammation. Pain 49:373–382Google Scholar
- 5.Page AJ, O’Donnell TA, Blackshaw LA (2000) P2X Purinoceptor-Induced Sensitization of Ferret Vagal Mechanoreceptors in Esophageal Inflammation. J Physiol 523:403–411Google Scholar
- 6.Patterson LM, Zheng H, Ward SM, Berthoud HR (2003) Vanilloid Receptor (VR1) Expression in Vagal Afferent Neurons Innervating the Gastrointestinal Tract. Cell Tissue Res 311:277–287Google Scholar
- 7.Qin C, Chandler MJ, Foreman RD (2003) Afferent Pathways and Responses of T3–T4 Spinal Neurons to Cervical and Thoracic Esophageal Distensions in Rats. Auton Neurosci 109:10–20Google Scholar
- 8.Qin C, Chandler MJ, Jou CJ, Foreman RD (2004) Response and Afferent Pathways of C1–C2 Spinal Neurons to Cervical and Thoracic Esophageal Stimulation in Rats. J Neurophysiol 91:2227–2235Google Scholar
- 9.Richter JE (1998) Dysphagia, Odynophagia, Heartburn and Other Esophageal Symptoms. In: Feldman M, Scharschmidt BF, Sleisenger M, Zorab R (eds) Gastrointestinal and Liver Disease. W.B. Saunders Company, Philadelphia, pp 97–105Google Scholar
- 10.Sarkar S, Hobson AR, Furlong PL, Woolf CJ, Tomson DG, Aziz Q (2001) Central Neural Mechanisms Mediating Human Visceral Hypersensitivity. Am J Physiol 281:G1196–G1202Google Scholar
- 11.Sengupta JN, Gebhart GF (1994) Gastrointestinal Afferents Fibers and Sensation. In: Johnson LR (ed) Physiology of the Gastrointestinal Tract Raven Press, New York, pp 483–519Google Scholar
- 12.Ward SM, Bayguinov J, Won KJ, Grundy D, Berthoud HR (2003) Distribution of the Vanilloid Receptor (VR1) in the Gastrointestinal Tract. J Comp Neurol 465:121–235Google Scholar
- 13.Hu WH, Martin CJ, Talley NJ (2000) Intraesophageal Acid Perfusion Sensitizes the Esophagus to Mechanical Distension: A Barostat Study. Am J Gastrol 95:2189–2194Google Scholar
- 14.Willert PR, Woolf CJ, Hobson AR, Delaney C, Thomson D, Aziz Q (2004) The Development and Maintenance of Human Visceral Pain Hypersensitivity is Dependent on the N-methyl-D-aspartate Receptor. Gastrolenterology 126:683–692Google Scholar
- 15.Zhang L, Jones S, Brody K, Costa M, Brookes SJH (2004) Thermosensitive Transient Receptor Potential Channels in Vagal Afferent Neurons of the Mouse. Am J Physiol 286:G983–G991Google Scholar