Symptom severity and clinical characteristics of patients with bloating

Abstract

Background: Abdominal bloating is common in functional gastrointestinal disorders (FGID). To better characterize this patient population, we evaluated clinical and psychological characteristics of bloating and analyzed their differences by bloating severity.Methods: Patients with FGIDs evaluated at a single academic outpatient referral gastroenterology clinic were surveyed. Bloating severity was classified as minimal, moderate or severe. Symptom-specific questionnaires were used to evaluate bowel habits, abdominal bloating, depression, anxiety, somatization and sleep disturbance. Associations between bloating severity, clinical characteristics and FGID subtypeswere analyzed in univariate and multivariate modeling.Key Results: Of 612 FGID patients included (78% female, mean age of 44 ± 16.5 years), bloating was reported as minimal in 231(37.8%), moderate in 217(35.4%), or severe in 164(26.8%). Patients with severe bloating were more likely to be female, younger, and have co-existing functional dyspepsia than those with minimal bloating (p < 0.05).Bloating severity and severity of abdominal distension were significantly correlated (p < 0.05). On multivariable regression, patients who met criteria for functional constipation and functional dyspepsia had 80% and 125% higher odds, respectively, of severe bloating compared to minimal to moderate bloating. Younger age, abdominal pain and constipation severity, and somatization scores were also independently associated with severity of bloating. Conclusions & Inferences:Severe bloating is associated with younger age, and with more severe abdominal pain, constipation, and somatization. Patients who met criteria for functional constipation and functional dyspepsia are more likely to experience severe bloating.

Pictograms to assess bloating and distension symptoms in the general population in Mexico: Results of The Rome Foundation Global Epidemiology Study

“…In fact, the high frequency of bloating and/or distension that we found in subjects with any esophageal disorders (90.7%), was similar to that in subjects with any gastroduodenal (92.1%), any bowel (90.7%), and any anorectal (91.7%); somewhat similar to the frequencies found with the pictograms, esophageal (84.7%), gastroduodenal (88.1%), bowel (79.8%), and anorectal (86.2%). The above data support the overlap of other functional symptoms in individuals meeting the criteria for any DGBI, and that bloating and/or distension are very common symptoms 4,15,16 …”

Management of bloating

“…A parallel study assessing the severity of bloating in patients with functional gastrointestinal disorders shows that severe bloating is more commonly referred by patients with functional dyspepsia and constipation. In addition, the severity of bloating is associated with younger age, and with more severe abdominal pain, constipation, and somatization 11 . These studies advance our understanding of the clinical characteristics and relevance of gas‐related symptoms in the broad spectrum of functional gastrointestinal disorders and make available a useful new tool to quantify the relevance of bloating in patients with functional gastrointestinal disorders.…”

“…In addition, the severity of bloating is associated with younger age, and with more severe abdominal pain, constipation, and somatization. 11 These studies advance our understanding of the clinical characteristics and relevance of gas-related symptoms in the broad spectrum of functional gastrointestinal disorders and make available a useful new tool to quantify the relevance of bloating in patients with functional gastrointestinal disorders.…”

“…Severe bloating is more commonly referred by patients with functional dyspepsia and constipation. In addition, the severity of bloating is associated with younger age, and with more severe abdominal pain, constipation, and somatization 11 . Taking together both published studies, the importance to use validated questionnaires to assess, not only the presence of bloating, but also the impact of severe bloating on patients with functional gastrointestinal disorders is highlighted, rising awareness about the relevance of these symptoms and opening the door to a better assessment of these patients, both in clinical trials as well as in daily clinical praxis.…”

Abdominophrenic Dyssynergia: A Narrative Review

“…Although bloating and distension are associated with a wide range of pathologies (both gastrointestinal and nongastrointestinal) (Table 1 ), these symptoms are particularly common in DGBIs such as irritable bowel syndrome (IBS) and functional dyspepsia (FD). Indeed, up to 90% of patients with IBS and 85% of patients with DGBIs regularly experience these symptoms ( 8 , 10 ). Multiple mechanisms may contribute to bloating and distension in DGBIs, including dysbiosis, small intestine bacterial overgrowth, dysmotility, pelvic floor dysfunction, aerophagia, abnormal gas handling, carbohydrate intolerance or malabsorption, visceral hypersensitivity, central sensitization, and abnormal viscerosomatic responses ( 11 , 12 ).…”