Approach to the Patient with Gas and Bloating

Rao, Satish S.; Lee, Yeong Yeh

doi:10.1002/9781118512074.ch40

Cited by 2 publications

(2 citation statements)

References 203 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Abdominal bloating, gas and distension are common gastrointestinal symptoms that are caused by many conditions including carbohydrate intolerance and small intestinal bacterial overgrowth (SIBO) 1 . Brain Fogginess (BF) describes a constellation of symptoms comprised of mental confusion, impaired judgment, poor short-term memory, and difficulty with concentration, which is often transient and disabling.…”

Section: Introductionmentioning

confidence: 99%

Brain fogginess, gas and bloating: a link between SIBO, probiotics and metabolic acidosis

Rao

Rehman

et al. 2018

Clinical and Translational Gastroenterology

114

View full text Add to dashboard Cite

BackgroundD-lactic acidosis is characterized by brain fogginess (BF) and elevated D-lactate and occurs in short bowel syndrome. Whether it occurs in patients with an intact gut and unexplained gas and bloating is unknown. We aimed to determine if BF, gas and bloating is associated with D-lactic acidosis and small intestinal bacterial overgrowth (SIBO).MethodsPatients with gas, bloating, BF, intact gut, and negative endoscopic and radiological tests, and those without BF were evaluated. SIBO was assessed with glucose breath test (GBT) and duodenal aspiration/culture. Metabolic assessments included urinary D-lactic acid and rblood L-lactic acid, and ammonia levels. Bowel symptoms, and gastrointestinal transit were assessed.ResultsThirty patients with BF and 8 without BF were evaluated. Abdominal bloating, pain, distension and gas were the most severe symptoms and their prevalence was similar between groups. In BF group, all consumed probiotics. SIBO was more prevalent in BF than non-BF group (68 vs. 28%, p = 0.05). D-lactic acidosis was more prevalent in BF compared to non-BF group (77 vs. 25%, p = 0.006). BF was reproduced in 20/30 (66%) patients. Gastrointestinal transit was slow in 10/30 (33%) patients with BF and 2/8 (25%) without. Other metabolic tests were unremarkable. After discontinuation of probiotics and a course of antibiotics, BF resolved and gastrointestinal symptoms improved significantly (p = 0.005) in 23/30 (77%).ConclusionsWe describe a syndrome of BF, gas and bloating, possibly related to probiotic use, SIBO, and D-lactic acidosis in a cohort without short bowel. Patients with BF exhibited higher prevalence of SIBO and D-lactic acidosis. Symptoms improved with antibiotics and stopping probiotics. Clinicians should recognize and treat this condition.

show abstract

Section: Introductionmentioning

confidence: 99%

Brain fogginess, gas and bloating: a link between SIBO, probiotics and metabolic acidosis

Rao

Rehman

et al. 2018

Clinical and Translational Gastroenterology

114

View full text Add to dashboard Cite

show abstract

“…Likewise, new triggers including new enteric infection in the form of small intestinal bacterial overgrowth (SIBO) or intestinal dysbiosis, that is often unsuspected in IBS or IBD, may have sustained the low-grade inflammation. Bloating is a common symptom present in both disorders, and SIBO is a cause of bloating that can be excluded easily through hydrogen breath testing 5758…”

Section: Ibs-ibd Disease Paradigmsmentioning

confidence: 99%

Irritable bowel syndrome and inflammatory bowel disease overlap syndrome: pieces of the puzzle are falling into place

2016

Self Cite

View full text Add to dashboard Cite

Irritable bowel syndrome (IBS), a common gastrointestinal disorder involving the gut-brain axis, and inflammatory bowel disease (IBD), a chronic relapsing inflammatory disorder, are both increasing in incidence and prevalence in Asia. Both have significant overlap in terms of symptoms, pathophysiology, and treatment, suggesting the possibility of IBS and IBD being a single disease entity albeit at opposite ends of the spectrum. We examined the similarities and differences in IBS and IBD, and offer new thoughts and approaches to the disease paradigm.

show abstract

Approach to the Patient with Gas and Bloating

Cited by 2 publications

References 203 publications

Brain fogginess, gas and bloating: a link between SIBO, probiotics and metabolic acidosis

Brain fogginess, gas and bloating: a link between SIBO, probiotics and metabolic acidosis

Irritable bowel syndrome and inflammatory bowel disease overlap syndrome: pieces of the puzzle are falling into place

Contact Info

Product

Resources

About