Relationship of Abdominal Bloating to Distention in Irritable Bowel Syndrome and Effect of Bowel Habit

Houghton, Lesley A.; Lea, Richard; Agrawal, A.; Reilly, Brian; Whorwell, Peter J.

doi:10.1053/j.gastro.2006.07.015

Cited by 123 publications

(132 citation statements)

References 47 publications

Supporting

Mentioning

113

Contrasting

Unclassified

Order By: Relevance

“…In a study conducted by Chang et al (15) on IBS patients, all cases who experienced bloating had normal levels of psychological symptoms, including anxiety, depression, and somatization, based on the Symptom Checklist-90-Revised. In another study conducted on IBS patients by Houghton et al (43), no significant relationship was found between bloating and psychological distress. Heitkemper et al (44) were also unable to demonstrate an association between bloating and psychological distress.…”

Section: Associations With Anxiety Depression and Psychological Dismentioning

confidence: 85%

“…The higher prevalence of bloating in IBS-C subjects may be due to the possible pathophysiology of bloating, which has been explained in previous studies: increased intestinal gas accumulation, which is mostly seen in constipated subjects due to slower than normal colonic transit, is an important cause of bloating (4,14,49). However, in some other studies, the prevalence of bloating was higher in IBS-D patients than in IBS-C subjects (4,15,30,43). Some studies have also found equally high prevalences of bloating for both IBS-D and IBS-C (5).…”

Section: Bloating In Other Gastrointestinal Disordersmentioning

confidence: 91%

See 1 more Smart Citation

Risk factors of bloating and its association with common gastrointestinal disorders in a sample of Iranian adults

Keshteli

Daneshpajouhnejad

Adibi³

2017

Turk J Gastroenterol

View full text Add to dashboard Cite

Background/Aims: Bloating is an unpleasant but common gastrointestinal symptom that is experienced by many people at some stage in their lives. The current survey was conducted to investigate the epidemiology and risk factors of bloating and functional bloating (FB). In addition, we aimed to assess the association between bloating and functional gastrointestinal disorders (FGIDs). Materials and Methods: In this cross-sectional study, the self-administered modified Rome III questionnaire was used to assess gastrointestinal symptoms and FGIDs. Severity of bloating, demographic and anthropometric measurements, physical activity level, psychological distress, and depression and anxiety were also assessed. Results: Among the 4763 participants, 52.9% reported having experienced bloating at least occasionally in the past three months (among which 14.1% had severe or very severe symptoms); 19.7% of subjects were found to have FB. After adjusting for multiple variables, female gender, university degree, obesity, and anxiety were associated with both bloating and FB, while depression and psychological distress were only associated with bloating. The positive predictive value and negative predictive value of bloating for the diagnosis of functional bowel disorder were 92.9% and 80.1%, respectively. Conclusion: Bloating and FB are highly prevalent in the study population. We also identified several demographic, psychological, and lifestyle-related risk factors of bloating in this population. Keywords: Bloating, functional bloating, functional gastrointestinal disorders, Iran, epidemiology Original Article retention, weak anterior wall muscle tone, abnormal gut microflora, inflammation, and altered bowel tonic and phasic motility, none of these has been scientifically proven (3,14). However, studies have shown both increased intestinal gas accumulation and delayed gas transit to be important causes of bloating. Distorted perception and visceral hyperalgesia may also play a role in some patients (2,3,5,14).Physical exercise accelerates gut transit and thus reduces bloating; however, studies on healthy subjects found that physical activity accelerated gas transit but did not affect bloating. The relationship between physical activity and bloating remains unclear (5). Obesity is also an established risk factor for FGIDs; however, data regarding its effects on bloating contain discrepancies (14). Psychological therapies have also been found to be useful in improving bloating and several other FGIDs; however, it remains unclear whether an actual relationship exists between bloating and psychosocial distress (2). Studies have also evaluated the associations of bloating with smoking, marital status, age, and education level (4,5,7); however, data confirming the associations of these variables is limited.The prevalence of bloating, as a symptom, is dramatically higher in subjects who suffer from other FGIDs, notably irritable bowel syndrome (IBS) (4). Studies have shown that more than two thirds of IBS patients may complain ...

show abstract

Section: Associations With Anxiety Depression and Psychological Dismentioning

confidence: 85%

Section: Bloating In Other Gastrointestinal Disordersmentioning

confidence: 91%

Risk factors of bloating and its association with common gastrointestinal disorders in a sample of Iranian adults

Keshteli

Daneshpajouhnejad

Adibi³

2017

Turk J Gastroenterol

View full text Add to dashboard Cite

show abstract

“…Isso pode aparecer abruptamente e ser devido à uma contração reflexa do diafragma combinada com o relaxamento dos músculos abdominais (9) . Apesar de flatulência e distensão poderem ocorrer no mesmo paciente, inchaço geralmente reflete um fenômeno perceptivo ou sensorial, considerando-se que distensão indica uma mudança observável no diâmetro da parede abdominal (10) . Recentemente, medições objetivas confirmaram que perímetro abdominal normalmente aumenta ligeiramente durante o dia, caindo abruptamente quando deita-se para dormir e, aumentando ao levantar-se.…”

Section: Distensão Abdominal E Inchaçounclassified

“…Recentemente, medições objetivas confirmaram que perímetro abdominal normalmente aumenta ligeiramente durante o dia, caindo abruptamente quando deita-se para dormir e, aumentando ao levantar-se. O aumento diurno é maior que o normal em pacientes com SII e constipação (10) . Apenas a metade dos pacientes de SII que relatam a sensação de inchaço tem distensão acima da faixa normal.…”

Section: Distensão Abdominal E Inchaçounclassified

[No Title Available]

Spiller

Thompson²

2012

Arq. Gastroenterol.

View full text Add to dashboard Cite

Os principais sintomas de origem intestinal são: dor abdominal ou desconforto, hábito intestinal alterado, distensão abdominal e borborigmos. Dor abdominal/desconfortoAs características da dor abdominal incluem a localização, a irradiação (se houver), o caráter (ardor, em pontadas, cólicas), padrão e duração (desde o início e a duração da crise) e fatores precipitantes e de alívio. Dor abdominal ou desconforto de origem gastrointestinal funcional surge da estimulação dos nervos viscerais: normalmente é difusa e mal localizada, muitas vezes no abdome inferior ou central. Quando perguntado para demonstrá-la, o paciente pode usar uma mão estendida, colocada sobre a área. Dados que sugerem a origem gastrointestinal da dor abdominal incluem exacerbação ao comer e alívio por defecação, sendo esta última parte dos critérios diagnósticos para síndrome do intestino irritável (SII). No entanto, apesar da alimentação aumentar a motilidade do cólon, pode produzir desconforto por meia hora depois , sendo característica de muitas doenças gastrointestinais. Portanto, a dor após refeições não faz parte dos critérios diagnósticos para a SII.Em contraste, quando doença visceral está associada com a estimulação dos neurônios somáticos, a dor é localizada mais precisamente. Diverticulite e apendicite são exemplos de doença intra-abdominal que, inicialmente são mal localizados, porque uma leve inflamação afeta apenas os neurônios viscerais. No entanto, quando a inflamação progride e atinge o peritônio parietal, a dor abdominal somática mais precisamente localizada é experimentada. Outros exemplos incluem a irradiação para as costas, que é típica de doença pancreática ou de úlcera duodenal penetrante.Dor em parede abdominal devida à hérnia de Spigelian (hérnia através da fáscia aponeurótica lateral ao músculo retoabdominal), lesão no músculo reto ou síndrome de dor em costelas é também localizada com mais precisão. Dor de tais causas pode ser identificada pelo teste do Carnett, no qual o paciente dobra seus braços sobre o peito e levanta sua cabeça contra a resistência suave. Exacerbação da dor por enrijecer os músculos retos desta forma, indica um distúrbio de parede abdominal (1) . Dor na caixa torácica é também precisamente localizada e agravada pela pressão local ou compressão. Reconhecimento precoce destas fontes somáticas menos comuns de dor abdominal pode evitar muita investigação fútil (2) . A dor abdominal da SII é visceral por natureza e geralmente episódica e imprevisível. Períodos de dor reaparecem durante uma mediana (intervalo) de 3 dias (2)(3)(4)(5)(6)(7)(8) , intercalados com alguns dias sem dor (3) . No entanto, em alguns casos, períodos dolorosos podem ser mais prolongados. Uma característica crucial da dor abdominal de SII é a associação temporal com hábito intestinal alterado. Uma alteração na frequên-cia e consistência das evacuações simultânea com a dor é um fenômeno usado nos critérios de Manning. Para a SII, esses recursos têm sensibilidade de SII desde 0,39 -0.6 e uma especificidade de 0,66 -0,77 com relação ...

show abstract

“…Typically, the symptom is variably reported over the months and fluctuates in intensity over daytime, particularly in the postprandial period, being worse at the end of the day and improving at night-time [11,21] . Changes in abdominal girth are greater in patients with IBS, and these patients are more likely to be symptomatic [22] . The severity of bloating may, therefore, vary from very mild to severe and uncomfortable [15] .…”

Section: Introductionmentioning

confidence: 99%

Bloating and functional gastro-intestinal disorders: Where are we and where are we going?

Iovino

Bucci

Tremolaterra

et al. 2014

WJG

View full text Add to dashboard Cite

Bloating is one of the most common and bothersome symptoms complained by a large proportion of patients. This symptom has been described with various definitions, such as sensation of a distended abdomen or an abdominal tension or even excessive gas in the abdomen, although bloating should probably be defined as the feeling (e.g. a subjective sensation) of increased pressure within the abdomen. It is usually associated with functional gastrointestinal disorders, like irritable bowel syndrome, but when bloating is not part of another functional bowel or gastrointestinal disorder it is included as an independent entity in Rome Ⅲ criteria named functional bloating. In terms of diagnosis, major difficulties are due to the lack of measurable parameters to assess and grade this symptom. In addition, it is still unclear to what extent the individual patient complaint of subjective bloating correlates with the objective evidence of abdominal distension. In fact, despite its clinical, social and economic relevance, bloating lacks a clear pathophysiology explanation, and an effective management endorsement, turning this common symptom into a true challenge for both patients and clinicians. Different theories on bloating etiology call into questions an increased luminal contents (gas, stools, liquid or fat) and/or an impaired abdominal empting and/or an altered intra-abdominal volume displacement (abdomino-phrenic theory) and/ or an increased perception of intestinal stimuli with a subsequent use of empirical treatments (diet modifications, antibiotics and/or probiotics, prokinetic drugs, antispasmodics, gas reducing agents and tricyclic antidepressants). In this review, our aim was to review the latest knowledge on bloating physiopathology and therapeutic options trying to shed lights on those processes where a clinician could intervene to modify disease course. Key words: Bloating; Functional gastro-intestinal disorders; Irritable bowel syndrome; Constipation; Diarrhea Core tip: Bloating is one of the most common and bothersome symptoms complained by a large proportion of patients, mostly with functional gastrointestinal disorders, but when bloating is not part of another functional bowel or gastrointestinal disorder it is included as an independent entity in Rome Ⅲ criteria named functional bloating. Despite its clinical, social and economic Iovino P et al . Bloating and functional gastro-intestinal disorders relevance, bloating lacks a clear pathophysiology explanation and an effective management endorsement. Moreover, it is unclear to what extent subjective complaint of bloating correlates with the objective evidence of abdominal distension. The aim of this paper is to review the latest knowledge on bloating and to explore future research directions to improve its management.

show abstract

Relationship of Abdominal Bloating to Distention in Irritable Bowel Syndrome and Effect of Bowel Habit

Cited by 123 publications

References 47 publications

Risk factors of bloating and its association with common gastrointestinal disorders in a sample of Iranian adults

Risk factors of bloating and its association with common gastrointestinal disorders in a sample of Iranian adults

[No Title Available]

Bloating and functional gastro-intestinal disorders: Where are we and where are we going?

Contact Info

Product

Resources

About