Mechanisms of abdominal distension in severe intestinal dysmotility: abdomino‐thoracic response to gut retention

Barba, Elizabeth; Quiroga, S.; Accarino, Anna; Lahoya, Eva Monclús; Malagelada, Carolina; Burri, Emanuel; Navazo, Isabel; Malagelada, Juan–R.; Azpiroz, Fernando

doi:10.1111/nmo.12128

Cited by 25 publications

(22 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The program was originally validated in vivo by measuring intestinal gas before and after injection of known volumes of air within the gut . Gas volumes measured in different studies were similar and no trend over time was observed . Using a three‐dimensional reconstruction program with 360° rotation over the three dimensions, gas volumes in selected regions of the gut were also measured.…”

Section: Methodsmentioning

confidence: 99%

“…Experimental human studies have shown that, in response to jejunal gas infusion, patients with abdominal bloating develop gas retention and symptoms, whereas healthy subjects tolerate and rapidly expel the infused gas loads . In apparent conflict with these earlier observations, when such patients complaining of abdominal distension were specifically investigated, only minor abnormalities in intraluminal gas volume and/or distribution were detected either during basal conditions or during symptomatic episodes with abdominal distension . However, due to the limited sample size of healthy subjects and patients included in previous individual studies, undetected abnormalities related to a type II error could not be excluded.…”

Section: Introductionmentioning

confidence: 93%

“…The goal of this study was to define the normal values of intestinal gas volume and distribution, and to identify abnormalities in intestinal gas in relation to functional‐type abdominal symptoms. To this aim, we pooled the data from previous studies in healthy subjects and in patients with symptoms commonly ascribed to excess intestinal gas, such as bloating, abdominal distension and flatulence, performed over the past 10 years in our laboratory under a standard protocol for abdominal computed tomography (CT) imaging . In this study, morphovolumetric analysis techniques previously developed in our laboratory have been applied together with new tools specifically developed under the current project.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Intestinal gas content and distribution in health and in patients with functional gut symptoms

Bendezú

Barba

Burri

et al. 2015

Neurogastroenterology Motil

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Intestinal gas content and distribution in health and in patients with functional gut symptoms

Bendezú

Barba

Burri

et al. 2015

Neurogastroenterology Motil

Self Cite

View full text Add to dashboard Cite

show abstract

“…Colonic content and motility are relevant factors when investigating treatments of a number of disorders, such as constipation and irritable bowel syndrome . Knowledge of the distribution of intestinal gas content throughout the gastrointestinal (GI) tract has helped to understand the cause of abdominal symptoms such as bloating and abdominal distension …”

mentioning

confidence: 99%

MRI analysis of fecal volume and dryness: Validation study using an experimental oxycodone‐induced constipation model

Mark

Bodker

Grønlund

et al. 2019

Magnetic Resonance Imaging

View full text Add to dashboard Cite

Background Opioids are known to affect gastrointestinal motility, but their effect on fluid absorption and secretion is poorly understood in humans. Purpose To investigate the effect of oxycodone on colonic fecal volume and stool dryness by using a novel MRI‐based technique. Study Type Prospective, randomized, double‐blinded, crossover study. Subjects Twenty‐five healthy male volunteers (median age: 24 years [range: 21–56]; mean body mass index [BMI]: 23.9 kg/m2 [range: 22.9–25.0]) without known gastrointestinal disease. Field Strength/Sequence T2‐weighted and two‐point Dixon MRI scans of the abdomen at 1.5 T. Assessment Subjects were treated for 5 days with prolonged‐release oxycodone or a placebo. Imaging was performed on the first and last study day in each period. Images of the colon were analyzed with semiautomatic k‐means‐based segmentation software. Regional colonic fecal volumes were quantified excluding gas volume and colon wall. Two‐point Dixon and T2‐weighted MRI signal intensity were assessed as a proxy of colonic stool dryness. Data were obtained in a previously reported study. Statistical Tests Intraclass correlation coefficients were used to test the reliability of measurements between days, while repeated measures mixed models were applied to test treatment effects. Results After oxycodone treatment, total colonic fecal volume was significantly increased compared with placebo (mean change 100 mL vs. –13 mL; P = 0.001), with the largest increase (24%) observed in the ascending colon/cecum (P = 0.001). Dixon signal increased (less water in colon content) after oxycodone treatment compared with placebo (mean 0.09 vs. –0.02; P < 0.001). T2‐weighted signal decreased (less water in colon content) after oxycodone treatment compared with placebo (mean –0.03 vs. 0.03; P = 0.002). Data Conclusion The 5‐day oxycodone treatment increased colonic fecal volume and increased stool dryness compared with placebo. This imaging‐based method for noninvasive analysis of colon content has the potential to characterize gastrointestinal symptoms in general, such as in constipation. Level of Evidence: 2 Technical Efficacy Stage: 1 J. Magn. Reson. Imaging 2019;50:733–745.

show abstract

“…The abdominal wall actively adapts to its content by a tight regulation of its muscular activity . Considering these two elements, ie wall and content, abdominal distension in patients may be related to either an increase in abdominal content, eg intestinal gas accumulation, or to a dyssynergia of the abdominal walls and redistribution of normal content; the latter is a conditioned response that can be corrected by behavioral treatment …”

Section: Introductionmentioning

confidence: 99%

Abdominal distension after eating lettuce: The role of intestinal gas evaluated in vitro and by abdominal CT imaging

Barba

Sánchez

Burri

et al. 2019

Neurogastroenterology Motil

View full text Add to dashboard Cite

BackgroundSome patients complain that eating lettuce, gives them gas and abdominal distention. Our aim was to determine to what extent the patients' assertion is sustained by evidence.MethodsAn in vitro study measured the amount of gas produced during the process of fermentation by a preparation of human colonic microbiota (n = 3) of predigested lettuce, as compared to beans, a high gas‐releasing substrate, to meat, a low gas‐releasing substrate, and to a nutrient‐free negative control. A clinical study in patients complaining of abdominal distention after eating lettuce (n = 12) measured the amount of intestinal gas and the morphometric configuration of the abdominal cavity in abdominal CT scans during an episode of lettuce‐induced distension as compared to basal conditions.Key ResultsGas production by microbiota fermentation of lettuce in vitro was similar to that of meat (P = .44), lower than that of beans (by 78 ± 15%; P < .001) and higher than with the nutrient‐free control (by 25 ± 19%; P = .05). Patients complaining of abdominal distension after eating lettuce exhibited an increase in girth (35 ± 3 mm larger than basal; P < .001) without significant increase in colonic gas content (39 ± 4 mL increase; P = .071); abdominal distension was related to a descent of the diaphragm (by 7 ± 3 mm; P = .027) with redistribution of normal abdominal contents.Conclusion and InferencesLettuce is a low gas‐releasing substrate for microbiota fermentation and lettuce‐induced abdominal distension is produced by an uncoordinated activity of the abdominal walls. Correction of the somatic response might be more effective than the current dietary restriction strategy.

show abstract

Mechanisms of abdominal distension in severe intestinal dysmotility: abdomino‐thoracic response to gut retention

Cited by 25 publications

References 12 publications

Intestinal gas content and distribution in health and in patients with functional gut symptoms

Intestinal gas content and distribution in health and in patients with functional gut symptoms

MRI analysis of fecal volume and dryness: Validation study using an experimental oxycodone‐induced constipation model

Abdominal distension after eating lettuce: The role of intestinal gas evaluated in vitro and by abdominal CT imaging

Contact Info

Product

Resources

About