Perception of changes in wall tension of the proximal stomach in humans

Background-Hypersensitivity to distension of the stomach is a frequent find ing in functional dyspepsia. During gastric distension studies both wall te nsion and elongation are increased. Aim - We wished to distinguish changes in wall tension from changes in elon gation in the genesis of perception of mechanical stimuli originating from the proximal stomach in healthy subjects. Subjects and methods - Twenty six volunteers were studied using gastric bar ostat and antroduodenal manometry. In 14 subjects, stepwise isobaric and is ovolumetric distensions were performed before and during erythromycin infus ion. In all volunteers, on a separate occasion, phasic contractions of the proximal stomach were detected as intraballoon pressure increases during fi xed volume inflation. These contractions were matched with perception chang es during two 10 minute periods, before and during administration of erythr omycin. Results - Erythromycin significantly lowered the perception and discomfort thresholds during stepwise gastric distension. During fixed volume inflatio n, erythromycin increased the number and amplitude of fundic contractions a nd enhanced their perception from 51.1 (7.4)% to 64.0 (4.7)%. The proportio n of perception score increases coinciding with fundic contractions increas ed from 47.3 (0.7)% to 81.5 (0.5)%. The amplitude of correctly identified i solated fundic pressure waves was higher compared with non-identified waves . Conclusions - These results support the hypothesis that changes in gastric wall tension may be involved in the genesis of symptoms originating from th e stomach.