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B Coffin

Publications and source records attributed to B Coffin.

47 records · Page 3Linked to original sources
PubMed1994

Selective gastric hypersensitivity and reflex hyporeactivity in functional dyspepsia.

BACKGROUND/AIMS: We have previously shown that patients with functional dyspepsia are hypersensitive to gastric distention. The aim of this study was to establish whether this sensory disturbance was confined to the stomach and whether it was associated with gut reflex dysfunction. METHODS: In 10 selected patients with dyspepsia and 12 healthy controls, perception and gut reflex responses to gastric distention, duodenal distention, and somatic stimulation were measured. Standardized distentions at fixed pressures were performed by gastric and duodenal barostats. Perception was scored by a detailed symptom questionnaire; gut reflex responses were measured as isobaric volume changes by each barostat. Somatic transcutaneous electrical nerve stimulation was produced on the hand. Individual stimuli (2-minute duration) were randomly applied at 10-minute intervals in stepwise increments in search of the respective threshold for discomfort. RESULTS: Patients with dyspepsia had gastric hypersensitivity to distention (discomfort threshold at 6.4 +/- 0.4 mm Hg vs. 8.3 +/- 0.6 mm Hg in controls; mean +/- SE; P < 0.05), whereas duodenal and somatic sensitivity was normal. Furthermore, patients with dyspepsia explicitly recognized their clinical symptoms in all gastric but only in 58% +/- 12% of the duodenal distention trials. In addition, patients with dyspepsia showed defective gastric relaxatory responses to duodenal distention (68 +/- 30 mL gastric expansion vs. 239 +/- 12 mL in controls; P < 0.05). CONCLUSIONS: Patients with dyspepsia are selectively hypersensitive to gastric distention; this sensory dysfunction is associated with impaired reflex reactivity of the stomach.

Adult↗
PubMed1994

Somatic stimulation reduces perception of gut distention in humans.

BACKGROUND/AIMS: Perception of gut symptoms may depend on visceral sensory modulation, but the mechanisms are poorly understood. Based on somatosensory data, we hypothesized that somatic stimulation modulates perception of gut stimuli. METHODS: Perception and gut reflexes were measured in 8 healthy subjects in response to increasing gastric and duodenal distentions (stimulus-response trials) performed alone or with simultaneous application on the hand of either low (just perceivable) or high (nonpainful) transcutaneous electrical nerve stimulation (100 Hz, 100 microseconds). Fixed pressure distentions were performed in stepwise increments by gastric and duodenal barostats to determine the respective thresholds for discomfort. Perception was measured by a questionnaire, and gut reflex responses were measured as isobaric volume changes by the barostats. Individual stimuli of 2 minutes' duration were randomly applied at 10-minute intervals. RESULTS: Somatic stimuli increased the tolerance to gut distention, and this effect was more pronounced with high stimuli. The gastric threshold for discomfort was 7.3 +/- 0.5 mm Hg with high stimuli vs. 5.5 +/- 0.2 mm Hg without stimuli, and the duodenal discomfort threshold was 15.5 +/- 1.5 mm Hg with high stimuli vs. 13.5 +/- 1.4 mm Hg without stimuli; P < 0.05 for both. Somatic stimuli modified neither basal gut tone nor the relaxatory duodenogastric reflex induced by duodenal distention (gastric expansion by 203 +/- 48 mL with high stimuli and 208 +/- 73 mL without stimuli). CONCLUSIONS: Somatic stimulation reduces perception of gut distention without interfering with local and reflex gut responses.

Adult↗
PubMed1994

Ileal tone in humans: effects of locoregional distensions and eating.

Using an electronic barostat in the human terminal ileum, we studied ileal tone in response to various stimuli in 10 healthy volunteers. Phasic activity was also measured by manometry. Graded orad (ileal) and caudad (cecal) balloon distensions did not produce any significant changes in ileal tone at all levels tested, even when a sensation of discomfort was felt. A linear relationship between pressure and volume was observed during in situ isobaric ileal distensions. Meal induced a biphasic tonic response with a brief (20 min) and immediate decrease in intrabag volume (64 +/- 7% of preprandial value, P < 0.05), followed by a prolonged increase in intrabag volume (158 +/- 10% of preprandial value, P < 0.05). A significant correlation was found between volume variations and phasic activities during the first phase (r = 0.88, P < 0.05), whereas no correlation was found during the second phase (r = 0.55, NS). The administration of glucagon induced a significant increase in intrabag volume from 45 +/- 5 to 70 +/- 8 ml (P < 0.05). We conclude that 1) regional distensions do not influence ileal tone and phasic motility, 2) the ileum does not show accommodation to distensions, and 3) meal produces an immediate increase in phasic and tonic activity followed by a prolonged relaxation.

Adult↗
PubMed1990

Calcified hepatic and renal cysts in adult dominant polycystic kidney disease.

We report the case of a 56-year-old woman suffering from adult dominant polycystic kidney disease, treated by hemodialysis, in whom calcifications of the wall of hepatic and renal cysts developed. The possibility that cystic calcifications might be the consequence of secondary hyperparathyroidism is discussed.

Calcinosis↗
PubMedDate not supplied

[Chronic idiopathic constipation in adults. Pathogenesis and treatment].

The purpose of this review article is to outline the main factors underlying adult chronic idiopathic constipation (colic substrates, bacterial fermentation, colic peristalsis, perineal anomalies and psychological factors) as well as readily available exploratory methods (colic transit time, anorectal manometry). A review is made of the various therapeutic possibilities, taking into account hygienico-dietetic and pharmacological treatments (mono- or multifactorial laxatives), biofeedback and psychological approaches. The main cases seen in clinical practice are described.

Adult↗