Sensation evoked by esophageal distension in functional chest pain patients depends on mechanical stress rather than on ischemia

Background Functional chest pain is commonly reproduced by bag distension in the esophageal body. It is unknown whether such pain is primarily associated with mechanical stress and strain (force‐deformation) or with changes in mucosal perfusion. Methods Fourteen patients (6M, 8F, average age 55.9 years) underwent ramp bag distension before and after injection of 20 mg butylscopolamine bromide (BS) using a novel bag catheter incorporating endosonography and laser Doppler perfusion monitoring. Healthy subjects served as controls. Mucosal perfusion was evaluated and stress and strain were computed and related to the sensation. Key Results The symptom score increased with bag volume (P