Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Neurogastroenterol Motil. 2013 Sep;25(9):766-e580. doi: 10.1111/nmo.12172. Epub 2013 Jul 3.
Clinical data suggest gender differences in gastrointestinal pain, but very little experimental data exist. Esophageal painful thresholds to mechanical, thermal, electric, and chemical stimuli can be measured with the esophageal multimodal pain model. The aim was to measure the effect of gender and mild esophagitis on esophageal pain perception.
Thirty-five healthy asymptomatic volunteers [19 men, median age 29 (22-56 years)] underwent upper GI endoscopy, 24 h pH/impedance measurement, and multimodal esophageal pain stimulation before and after sensitization with acid. Stimulus intensities at painful thresholds were recorded.
Men had higher pain thresholds (PT) to mechanical stimulation (mean volume: men 20.9 ± 10 mL vs women 15.2 ± 6.8 mL, P = 0.02) and more men tolerated the maximum acid challenge (58% vs 20%, P = 0.03). There were no differences between genders for PT to (1) thermal stimulation [mean stimulation time (men, women): heat; 20 ± 5 s vs 21 ± 6 s or cold; 33.3 ± 20.1 s vs 20.7 ± 21.4 s, P > 0.2], (2) electrical current (mean current: men 17.6 ± 9.2 mA vs women 12.9 ± 3.7 mA, P = 0.11), or (3) acid volume [median volume: men 200 (20;200) mL vs women 133 (40;200) mL, P = 0.2]. Fifteen asymptomatic subjects had mild esophagitis (10 men, all Los Angeles A). There were no differences in esophageal PT between subjects with normal endoscopy or mild esophagitis (all P > 0.3).
CONCLUSIONS & INFERENCES: The effects of gender and mild esophagitis on esophageal multimodal pain perception have been measured in asymptomatic volunteers. The study suggests that gender, not mild esophagitis, tends to influence mechanical and chemical esophageal pain.
临床数据表明胃肠道疼痛存在性别差异，但仅有很少的实验数据存在。食管多模式疼痛模型可用于测量机械、热、电和化学刺激引起的食管疼痛阈值。本研究旨在测量性别和轻度食管炎对食管疼痛感知的影响。
35 名无症状志愿者[19 名男性，中位年龄 29（22-56 岁）]接受上消化道内镜检查、24 小时 pH/阻抗测量以及酸敏化前后的食管多模式疼痛刺激。记录疼痛阈值时的刺激强度。
男性对机械刺激的疼痛阈值（PT）更高（平均容量：男性 20.9±10ml 与女性 15.2±6.8ml，P=0.02），更多的男性能耐受最大酸挑战（58%与 20%，P=0.03）。男性与女性在以下方面的 PT 无差异：（1）热刺激[平均刺激时间（男性、女性）：热刺激 20±5s 与 21±6s，或冷刺激 33.3±20.1s 与 20.7±21.4s，P>0.2]；（2）电流（平均电流：男性 17.6±9.2mA 与女性 12.9±3.7mA，P=0.11）；或（3）酸容量[中位数容量：男性 200（20；200）ml 与女性 133（40；200）ml，P=0.2]。15 名无症状受试者存在轻度食管炎（10 名男性，均为洛杉矶 A 级）。内镜正常与轻度食管炎受试者的食管 PT 无差异（所有 P>0.3）。
本研究在无症状志愿者中测量了性别和轻度食管炎对食管多模式疼痛感知的影响。研究表明，性别而非轻度食管炎倾向于影响食管机械和化学疼痛。
