Intra-oesophageal balloon distension and oesophageal sensation in humans.

Intra-oesophageal balloon distension is a recognized stimulus for the assessment of oesophageal motor and sensory responses. It is increasingly being adopted by oesophageal laboratories, especially for the investigation of unexplained chest pain. The purpose of this paper is to review current knowledge concerning intra-oesophageal balloon distension. Perception of balloon distension is dependent upon demographic variables such as age, height and sex. Even when these are controlled for, patient groups are more sensitive to the stimulus than are healthy controls. This is true for patients with dysphagia and irritable bowel syndrome as well as those with unexplained chest pain. The role of intra-oesophageal balloon distension in determining oesophageal visceral hypersensitivity is outlined. In the investigation of unexplained chest pain, it may double the diagnostic yield of either acid perfusion or edrophonium provocation testing. Intra-oesophageal balloon distension has the potential to assess the response to therapy in patients with unexplained chest pain and has also been used in conjunction with cerebral evoked potential measurements to identify the afferent pathways involved. This technique provides another diagnostic tool that can readily be used in any oesophageal laboratory.