Intraesophageal balloon distention in the evaluation of sensory thresholds: studies on reproducibility and comparison of balloon composition.

Objective: Graded intraesophageal balloon distention has been suggested as a provocative test in the assessment of undetermined chest pain. Balloon distention was used to determine pain threshold reproducibility for 20 normal individuals (mean age: 27 yr).
Methods: Balloons made of silicone and latex were each evaluated in 10 subjects, with the balloon located 10 cm above the lower esophageal sphincter. The balloons were sequentially inflated with 2-cc increments of air by a specially designed pump to a total volume of 2 cc above the level of pain for each subject. A random series of inflations was also used. Three sets of both sequential (S) and random (R) inflations were performed on 2 subsequent days.
Results: With the silicone balloon, the mean volume for pain threshold was 15 +/- 1.1 cc (+/- SE) for S and 15 +/- 1.2 cc for R inflations on day 1 and 15 +/- 1.5 cc and 15 +/- 1.5 cc on day 2. For the latex balloons, the mean volume for pain threshold was 17 +/- 1.4 cc for S and 17 +/- 1.4 cc for R inflations on day 1 and 17 +/- 1.6 cc and 18 +/- 1.9 cc on day 2.
Conclusion: From these studies, we conclude that pain thresholds to esophageal balloon distention are reproducible with same or subsequent day testing. Similar effects occur with either silicone or latex balloons. In vitro studies on the inflation characteristics of the balloons indicate that the latex balloon inflates in a more even, linear manner, which makes this balloon more practical for evaluating pain thresholds in terms of air volume inflations.