Tags

Type your tag names separated by a space and hit enter

Bloating and distention in irritable bowel syndrome: the role of visceral sensation.
Gastroenterology 2008; 134(7):1882-9G

Abstract

BACKGROUND & AIMS

Abdominal bloating is an extremely intrusive symptom of irritable bowel syndrome (IBS) that is not always accompanied by an increase in abdominal girth (distention), raising the possibility that these 2 features of the condition may not share a common pathophysiology. A number of mechanisms have been postulated for bloating and distention, but the role of visceral sensation, which is often abnormal in IBS, has not been previously investigated, and this study aimed to address this question.

METHODS

Abdominal girth measured by ambulatory abdominal inductance plethysmography and bloating severity was recorded over 24 hours in 39 IBS-constipation (ages, 18-73 years) and 29 IBS-diarrhea patients (ages, 20-59 years) meeting Rome II criteria. Within 1 week, rectal sensory thresholds were assessed with a barostat using the ascending method of limits and tracking.

RESULTS

IBS patients who suffered with bloating alone had lower thresholds for pain (P = .005), desire to defecate (P = .044), and first sensation (P = .07) compared with those who had concomitant distention irrespective of bowel habit. When patients were grouped according to sensory threshold, hyposensitive individuals had distention significantly more than those with hypersensitivity (P = .001), and this was observed more in the constipation subgroup. Static and dynamic compliance did not differ among any of the groups.

CONCLUSIONS

The symptom of bloating alone is associated with visceral hypersensitivity, suggesting that the pathogenesis of bloating and distention may not be the same. Consequently, treatment approaches may have to be different, and measuring visceral sensation could have utility in choosing the right therapeutic modality.

Authors+Show Affiliations

Neurogastroenterology Unit, University of Manchester, Manchester, United Kingdom.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18455167

Citation

Agrawal, Anurag, et al. "Bloating and Distention in Irritable Bowel Syndrome: the Role of Visceral Sensation." Gastroenterology, vol. 134, no. 7, 2008, pp. 1882-9.
Agrawal A, Houghton LA, Lea R, et al. Bloating and distention in irritable bowel syndrome: the role of visceral sensation. Gastroenterology. 2008;134(7):1882-9.
Agrawal, A., Houghton, L. A., Lea, R., Morris, J., Reilly, B., & Whorwell, P. J. (2008). Bloating and distention in irritable bowel syndrome: the role of visceral sensation. Gastroenterology, 134(7), pp. 1882-9. doi:10.1053/j.gastro.2008.02.096.
Agrawal A, et al. Bloating and Distention in Irritable Bowel Syndrome: the Role of Visceral Sensation. Gastroenterology. 2008;134(7):1882-9. PubMed PMID: 18455167.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bloating and distention in irritable bowel syndrome: the role of visceral sensation. AU - Agrawal,Anurag, AU - Houghton,Lesley A, AU - Lea,Richard, AU - Morris,Julie, AU - Reilly,Brian, AU - Whorwell,Peter J, Y1 - 2008/03/08/ PY - 2007/08/08/received PY - 2008/02/06/revised PY - 2008/02/28/accepted PY - 2008/5/6/pubmed PY - 2008/7/8/medline PY - 2008/5/6/entrez SP - 1882 EP - 9 JF - Gastroenterology JO - Gastroenterology VL - 134 IS - 7 N2 - BACKGROUND & AIMS: Abdominal bloating is an extremely intrusive symptom of irritable bowel syndrome (IBS) that is not always accompanied by an increase in abdominal girth (distention), raising the possibility that these 2 features of the condition may not share a common pathophysiology. A number of mechanisms have been postulated for bloating and distention, but the role of visceral sensation, which is often abnormal in IBS, has not been previously investigated, and this study aimed to address this question. METHODS: Abdominal girth measured by ambulatory abdominal inductance plethysmography and bloating severity was recorded over 24 hours in 39 IBS-constipation (ages, 18-73 years) and 29 IBS-diarrhea patients (ages, 20-59 years) meeting Rome II criteria. Within 1 week, rectal sensory thresholds were assessed with a barostat using the ascending method of limits and tracking. RESULTS: IBS patients who suffered with bloating alone had lower thresholds for pain (P = .005), desire to defecate (P = .044), and first sensation (P = .07) compared with those who had concomitant distention irrespective of bowel habit. When patients were grouped according to sensory threshold, hyposensitive individuals had distention significantly more than those with hypersensitivity (P = .001), and this was observed more in the constipation subgroup. Static and dynamic compliance did not differ among any of the groups. CONCLUSIONS: The symptom of bloating alone is associated with visceral hypersensitivity, suggesting that the pathogenesis of bloating and distention may not be the same. Consequently, treatment approaches may have to be different, and measuring visceral sensation could have utility in choosing the right therapeutic modality. SN - 1528-0012 UR - https://www.unboundmedicine.com/medline/citation/18455167/Bloating_and_distention_in_irritable_bowel_syndrome:_the_role_of_visceral_sensation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(08)00433-2 DB - PRIME DP - Unbound Medicine ER -