Tags

Type your tag names separated by a space and hit enter

Bloating and distention in irritable bowel syndrome: the role of gas production and visceral sensation after lactose ingestion in a population with lactase deficiency.
Am J Gastroenterol. 2013 Sep; 108(9):1516-25.AJ

Abstract

OBJECTIVES

Bloating and distention are often attributed to dietary factors by patients with irritable bowel syndrome (IBS). This study examined the effects of gas production and visceral hypersensitivity on digestive symptoms after lactose ingestion in a population with lactase deficiency.

METHODS

IBS patients (n=277) and healthy controls (HCs, n=64) underwent a 20-g lactose hydrogen breath test (LHBT) with evaluation of hydrogen gas production and lactose intolerance (LI) symptoms. Abdominal distention (199 IBS, 40 HCs) was measured during LHBT. Rectal sensitivity (74 IBS, 64 HCs) was assessed by barostat studies.

RESULTS

Hydrogen production and distention were similar in IBS patients and HCs during LHBT; however, LI was more frequent in IBS (53.8 vs. 28.1%, P<0.001), especially bloating (39.0% vs. 14.1%, P<0.001) and borborygmi (39.0 vs. 21.9%, P=0.010). Only 59.0% of patients with bloating had distention. No correlation was observed between girth increment and bloating (P=0.585). IBS patients had lower rectal sensory thresholds (P=0.001). Multivariate analysis indicated that hydrogen production increased bloating (odds ratio (OR) 2.19, 95% confidence interval (CI) 1.09-4.39, P=0.028) and borborygmi (OR 12.37, 95% CI 3.34-45.83, P<0.001) but not distention (P=0.673). Visceral hypersensitivity was associated with bloating (OR 6.61, 95% CI 1.75-25.00, P=0.005) and total symptom score (OR 3.78, 95% CI 1.30-10.99, P=0.014).

CONCLUSIONS

Gas production and visceral hypersensitivity both contribute to digestive symptoms, especially bloating and borborygmi, in IBS patients after lactose ingestion. Objective abdominal distention is not correlated with subjective bloating.

Authors+Show Affiliations

Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.No affiliation info availableNo 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

23917444

Citation

Zhu, Yujin, et al. "Bloating and Distention in Irritable Bowel Syndrome: the Role of Gas Production and Visceral Sensation After Lactose Ingestion in a Population With Lactase Deficiency." The American Journal of Gastroenterology, vol. 108, no. 9, 2013, pp. 1516-25.
Zhu Y, Zheng X, Cong Y, et al. Bloating and distention in irritable bowel syndrome: the role of gas production and visceral sensation after lactose ingestion in a population with lactase deficiency. Am J Gastroenterol. 2013;108(9):1516-25.
Zhu, Y., Zheng, X., Cong, Y., Chu, H., Fried, M., Dai, N., & Fox, M. (2013). Bloating and distention in irritable bowel syndrome: the role of gas production and visceral sensation after lactose ingestion in a population with lactase deficiency. The American Journal of Gastroenterology, 108(9), 1516-25. https://doi.org/10.1038/ajg.2013.198
Zhu Y, et al. Bloating and Distention in Irritable Bowel Syndrome: the Role of Gas Production and Visceral Sensation After Lactose Ingestion in a Population With Lactase Deficiency. Am J Gastroenterol. 2013;108(9):1516-25. PubMed PMID: 23917444.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bloating and distention in irritable bowel syndrome: the role of gas production and visceral sensation after lactose ingestion in a population with lactase deficiency. AU - Zhu,Yujin, AU - Zheng,Xia, AU - Cong,Yanqun, AU - Chu,Hua, AU - Fried,Michael, AU - Dai,Ning, AU - Fox,Mark, Y1 - 2013/08/06/ PY - 2012/12/02/received PY - 2013/06/01/accepted PY - 2013/8/7/entrez PY - 2013/8/7/pubmed PY - 2013/11/5/medline SP - 1516 EP - 25 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 108 IS - 9 N2 - OBJECTIVES: Bloating and distention are often attributed to dietary factors by patients with irritable bowel syndrome (IBS). This study examined the effects of gas production and visceral hypersensitivity on digestive symptoms after lactose ingestion in a population with lactase deficiency. METHODS: IBS patients (n=277) and healthy controls (HCs, n=64) underwent a 20-g lactose hydrogen breath test (LHBT) with evaluation of hydrogen gas production and lactose intolerance (LI) symptoms. Abdominal distention (199 IBS, 40 HCs) was measured during LHBT. Rectal sensitivity (74 IBS, 64 HCs) was assessed by barostat studies. RESULTS: Hydrogen production and distention were similar in IBS patients and HCs during LHBT; however, LI was more frequent in IBS (53.8 vs. 28.1%, P<0.001), especially bloating (39.0% vs. 14.1%, P<0.001) and borborygmi (39.0 vs. 21.9%, P=0.010). Only 59.0% of patients with bloating had distention. No correlation was observed between girth increment and bloating (P=0.585). IBS patients had lower rectal sensory thresholds (P=0.001). Multivariate analysis indicated that hydrogen production increased bloating (odds ratio (OR) 2.19, 95% confidence interval (CI) 1.09-4.39, P=0.028) and borborygmi (OR 12.37, 95% CI 3.34-45.83, P<0.001) but not distention (P=0.673). Visceral hypersensitivity was associated with bloating (OR 6.61, 95% CI 1.75-25.00, P=0.005) and total symptom score (OR 3.78, 95% CI 1.30-10.99, P=0.014). CONCLUSIONS: Gas production and visceral hypersensitivity both contribute to digestive symptoms, especially bloating and borborygmi, in IBS patients after lactose ingestion. Objective abdominal distention is not correlated with subjective bloating. SN - 1572-0241 UR - https://www.unboundmedicine.com/medline/citation/23917444/Bloating_and_distention_in_irritable_bowel_syndrome:_the_role_of_gas_production_and_visceral_sensation_after_lactose_ingestion_in_a_population_with_lactase_deficiency_ L2 - http://Insights.ovid.com/pubmed?pmid=23917444 DB - PRIME DP - Unbound Medicine ER -