Looking for viscero-somatic or viscero-visceral reflex responsive to esophageal pain

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Richard E. Haas

Hello Ali,

Have you considered salivary alpha amylase?

Salivary amylase activity is useful for assessing perioperative stress in response to pain in patients undergoing endoscopic submucosal dissection of gastric tumors under deep sedation Gastric Cancer, 2010 13:2 84-9 DOI 10.1007/s10120-009-0541-8

Diagnostic Performance of Initial Salivary Alpha-Amylase Activity for Acute Myocardial Infarction in Patients with Acute Chest Pain The Journal of Emergency Medicine Volume 43, Issue 4, October 2012, Pages 553–560

Also Salimetrics, the company which measures these levels, has a rich library of studies and I have found them quite helpful https://www.salimetrics.com/

I have no financial or professional relationship to this company.

Finally, I believe there are bedside measurement kits available which are relatively inexpensive.

All the best,

Rich

Here is a subject matter expert on Researchgate on sAA

https://www.researchgate.net/profile/Peter_Butterworth

Ali Gholamrezaei

Hi Richard,

Thanks for the suggestion, but not useful for our study. What I need is a measure that is as dynamic as pain, so if an intervention decreases the pain it can be tracked by looking at the measure from moment to moment. And, it must be rapid, not lasting, and easy and not-expensive to measure. That's why I'm looking for a kind of reflex, something like nociception flexion reflex, but in the viscera.

Hi Ali

We monitor somatosensory evoked potentials in the operating room during back surgery to insure the patency of nervous function, but I would be uncertain if there is a simple way to a) find and then b) track the potentials for this part of the anatomy. If your institution has someone who does SSEP, they might have a better answer. Wish I had something better, look forward to following your project to see what you find. Are you measuring the pain during esophagoscopy, or are you looking for an external measure?

Cheers,

We use a tiny probe to deliver electrical stimulation at distal esophagus in healthy volunteers and they report perceived pain intensity. We can look at the ERPs, good suggestion, Tnx.