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Review article: the treatment of functional abdominal bloating and distension.
Aliment Pharmacol Ther. 2011 May; 33(10):1071-86.AP

Abstract

BACKGROUND

Abdominal bloating and distension are common symptoms in patients with functional gastrointestinal disorders (FGIDs), however, relatively little is known about their treatment.

AIM

To review the treatment trials for abdominal bloating and distension.

METHODS

A literature review in Medline for English-language publications through February 2010 of randomised, controlled treatment trials in adults. Study quality was assessed according to Jadad's score.

RESULTS

Of the 89 studies reviewed, 18% evaluated patients with functional dyspepsia, 61% with irritable bowel syndrome (IBS), 10% with chronic constipation and 10% with other FGIDs. No studies were conducted in patients diagnosed with functional abdominal bloating. The majority of trials investigated the efficacy of prokinetics or probiotics, although studies are heterogeneous with respect to diagnostic criteria and outcome measures. In general, bloating and/or distension were evaluated as secondary endpoints or as individual symptoms as part of a composite score rather than as primary endpoints. A greater proportion of IBS patients with constipation reported improvement in bloating with tegaserod vs. placebo (51% vs. 40%, P<0.0001) and lubiprostone (P<0.001). A greater proportion of nonconstipating IBS patients reported adequate relief of bloating with rifaximin vs. placebo (40% vs. 30%, P<0.001). Bloating was significantly reduced with the probiotics, Bifidobacterium infantis 35624 (1×10(8) dose vs. placebo: -0.71 vs. -0.44, P<0.05) and B. animalis (live vs. heat-killed: -0.56±1.01 vs. -0.31±0.87, P=0.03).

CONCLUSIONS

Prokinetics, lubiprostone, antibiotics and probiotics demonstrate efficacy for the treatment of bloating and/or distension in certain FGIDs, but other agents have either not been studied adequately or have shown conflicting results.

Authors+Show Affiliations

Laboratory of Liver, Pancreas and Motility, Department of Experimental Medicine-Faculty of Medicine, Universidad Nacional Autónoma de Mexico (UNAM), Mexico.No affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

21488913

Citation

Schmulson, M, and L Chang. "Review Article: the Treatment of Functional Abdominal Bloating and Distension." Alimentary Pharmacology & Therapeutics, vol. 33, no. 10, 2011, pp. 1071-86.
Schmulson M, Chang L. Review article: the treatment of functional abdominal bloating and distension. Aliment Pharmacol Ther. 2011;33(10):1071-86.
Schmulson, M., & Chang, L. (2011). Review article: the treatment of functional abdominal bloating and distension. Alimentary Pharmacology & Therapeutics, 33(10), 1071-86. https://doi.org/10.1111/j.1365-2036.2011.04637.x
Schmulson M, Chang L. Review Article: the Treatment of Functional Abdominal Bloating and Distension. Aliment Pharmacol Ther. 2011;33(10):1071-86. PubMed PMID: 21488913.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Review article: the treatment of functional abdominal bloating and distension. AU - Schmulson,M, AU - Chang,L, Y1 - 2011/03/29/ PY - 2011/4/15/entrez PY - 2011/4/15/pubmed PY - 2011/12/13/medline SP - 1071 EP - 86 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 33 IS - 10 N2 - BACKGROUND: Abdominal bloating and distension are common symptoms in patients with functional gastrointestinal disorders (FGIDs), however, relatively little is known about their treatment. AIM: To review the treatment trials for abdominal bloating and distension. METHODS: A literature review in Medline for English-language publications through February 2010 of randomised, controlled treatment trials in adults. Study quality was assessed according to Jadad's score. RESULTS: Of the 89 studies reviewed, 18% evaluated patients with functional dyspepsia, 61% with irritable bowel syndrome (IBS), 10% with chronic constipation and 10% with other FGIDs. No studies were conducted in patients diagnosed with functional abdominal bloating. The majority of trials investigated the efficacy of prokinetics or probiotics, although studies are heterogeneous with respect to diagnostic criteria and outcome measures. In general, bloating and/or distension were evaluated as secondary endpoints or as individual symptoms as part of a composite score rather than as primary endpoints. A greater proportion of IBS patients with constipation reported improvement in bloating with tegaserod vs. placebo (51% vs. 40%, P<0.0001) and lubiprostone (P<0.001). A greater proportion of nonconstipating IBS patients reported adequate relief of bloating with rifaximin vs. placebo (40% vs. 30%, P<0.001). Bloating was significantly reduced with the probiotics, Bifidobacterium infantis 35624 (1×10(8) dose vs. placebo: -0.71 vs. -0.44, P<0.05) and B. animalis (live vs. heat-killed: -0.56±1.01 vs. -0.31±0.87, P=0.03). CONCLUSIONS: Prokinetics, lubiprostone, antibiotics and probiotics demonstrate efficacy for the treatment of bloating and/or distension in certain FGIDs, but other agents have either not been studied adequately or have shown conflicting results. SN - 1365-2036 UR - https://www.unboundmedicine.com/medline/citation/21488913/Review_article:_the_treatment_of_functional_abdominal_bloating_and_distension_ L2 - https://doi.org/10.1111/j.1365-2036.2011.04637.x DB - PRIME DP - Unbound Medicine ER -