| Heather |
| () |
| 09/22/05 04:46 PM |
|
Abdominal Bloating
|
Gastroenterology
Volume 129, Issue 3 , September 2005, Pages 1060-1078
doi:10.1053/j.gastro.2005.06.062
Copyright © 2005 American Gastroenterological Association Published by Elsevier Inc.
Abdominal Bloating
Fernando Azpiroz, and Juan–R. Malagelada
Digestive System Research Unit, Hospital General Vall d’Hebron, Autonomous University of Barcelona, Barcelona, Spain
Received 5 August 2004; accepted 24 November 2004. Available online 6 September 2005.
Abdominal bloating is a common and significant clinical problem that remains to be scientifically addressed. Bloating is one of the most bothersome complaints in patients with various functional gut disorders. However, in the current standard classification, abdominal bloating is merely regarded as a secondary descriptor, which masks its real clinical effect.
Four factors are involved in the pathophysiology of bloating: a subjective sensation of abdominal bloating, objective abdominal distention, volume of intra-abdominal contents, and muscular activity of the abdominal wall. The primer to elicit subjective bloating may be any of the other 3 factors, or the sensation may be related to distorted perception.
All of these mechanisms may play an independent role or may be interrelated. Gas transit studies have evidenced that patients with bloating have impaired reflex control of gut handling of contents. Segmental pooling, either of gas or of solid/liquid components, may induce a bloating sensation, particularly in patients with altered gut perception.
Furthermore, altered viscerosomatic reflexes may contribute to abdominal wall protrusion and objective distention, even without major intra-abdominal volume increment. Bloating probably is a heterogeneous condition produced by a combination of pathophysiological mechanisms that differ among individual patients and that in most cases are subtle and undetectable by conventional methods.
Further advances in the pathophysiology and clinical forms of bloating are warranted to develop mechanistic strategies rather than the current empiric treatment strategies for comprehensive and effective management of this problem.
Supported in part by the National Institutes of Health (grant DK57064), the Spanish Ministry of Education (grant BFI 2002-03413), and the Instituto Carlos III (grant C03/02).
Gastroenterology
Volume 129, Issue 3 , September 2005, Pages 1060-1078
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WFX-4H2162R-1G&_user=10&_handle=V-WA-A-W-DD-MsSWYWW-UUW-U-AAWEAYVAVY-AAWZDZVEVY-BBCBAECAD-DD-U&_fmt=summary&_coverDate=09%2F30%2F2005&_rdoc=42&_orig=browse&_srch=%23toc%236806%232005%23998709996%23605535!&_cdi=6806&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=7663fa40aa8f7dc09ad26193f30710b2
