ABSTRACT
Mechano--and chemo--sensitivity were studied in 20 normal control patients and 73 patients suffering from pirosis, chest pain or both symptoms. Upper endoscopy, balloon and acid perfussion tests were performed. Balloon was inflated up to 15 ml. and deflated, in 2 cm. steps from 38 to 22 cm. from S.D.A. The number of patients with response, volume of balloon distension that evoked symptoms, place and irradiation of pain or discomfort were registered and plotted on 13 frontal and 10 dorsal zones. The total number of areas involved in pain irradiation was considered as [quot ]number of responses[quot ]. Nine levels were stimulated. Acid perfusion and clearance tests were performed at the same session. Test positivity was accepted when some test evoked spontaneous patients symptoms. RESULTS: When 9 levels were stimulated, balloon reproduced symptoms in 77.5
. If only one level was considered, the maximal rate was 51
, responses with volumes of + < 7 ml. were obtained. In all patients with chest pain upper endoscopy was normal. In 70
of the total group and in 62.5
of patients with pirosis the acid perfusion test was [quot ]positive[quot ]. Esophagitis increased the probability of a positive test. In sixty per cent, patients with combined pirosis and chest pain responded separately with each test. In 6
balloon evoked pirosis. CONCLUSION: 1) Balloon test could be considered the most useful test in mechano-sensitivity investigation. 2) acid perfussion was useful for chemo-sensitivity investigation. As esophagitis increases chemosensitivity, it could be a conditionant factor in some patients. 3) Patients with combined symptoms responded as a mixed sensorial dysfunction with each test. 4) sub-population of patients had atypical responses to the provocative tests.