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2018, Number 2

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Rev Med MD 2018; 9.10 (2)

Abdominal bloating

García-Jiménez ÉS,Velarde-Ruiz VJA, Rangel-Orozco MF, Briones-Govea D, Morel-Cerda EC, Barba-Orozco E

Language: Spanish
References: 44
Page: 164-173
PDF size: 646.26 Kb.


ABSTRACT

Abdominal distension (AB) is a frequent clinical condition and it may be present as the main and unique symptom of a functional disease called “functional abdominal distension”. It may also be present in other type of functional digestive pathologies. Two main terms are used to describe this entity: distension (visible increase of the abdominal perimeter, objective AB) and bloating (distension sensation experienced by the patient, subjective AB, imperceptible abdominal heaviness referred by patient).
Functional digestive disorders constitute a big social and sanitary problem, since they alter patients' life quality, daily habits and in some cases, it may become incapacitating. This is a cause of social pressure and absenteeism. AB from other entities, must be distinguished true AB defined by the Rome IV criteria. This can only be achieved with an ordered and individualized approach, in order to differentiate functional and structural conditions, and start specific treatment. Expensive and complicated testing is not routinely recommended, unless warning characteristics are present. During diagnostic approach, we must always consider complete medical history, clinical picture and important antecedents, before deciding investigation strategies.
Different treatment strategies have been proposed for AB including life style changes, diet, drugs, and neuromodulation and bioretroalimentation training. This review provides general and pathophysiological aspects, approach and treatment of AB.


REFERENCES

  1. Burri E, Cisternas D, Villoria A, Accarino A, Soldevilla A, Malagelada JR, et al. Accomodation of the abdomen to its content: integrated abdominothoracic response. Neurogastroenterol Motil. 2012 Apr;24(4):312-e162

  2. 2.Chang L, Lee OY, Naliboff B, Schmulson M, Mayer EA. Sensation of bloating and visible abdominal distension in patients with irritable bowel syndrome. Am J Gastroenterol. 2001 Dic;96(12):3341-7

  3. 3.Azpiroz F, Malagelada JR. Abdominal bloating. Gastroenterology. 2005 Sep;129(3)1060-78 Referencias bibliográficas

  4. 4.Tuteja AK, Talley NJ, Joos SK, Tolman KG, Hickam DH. Abdominal bloating in employed adults: prevalence, risk factors, and association with other b owe ldisorders. Am J Gastroenterol. 2 0 0 8 May;103(5):1241-8

  5. 5.Foley A, Burgell R, Barrett JS, Gibson PR. Management strategies for abdominal bloating and distension. Gastroenterol Hepatol. 2014 Sep;10(9):561:571

  6. 6.Lacy BE, Mearin F, Chang L, Chey WD, Lembo AJ, Simren M, et al. Bowel disorders. Gastroenterology. 2016;150:1393-1407

  7. 7.Schmulson MJ, Drossman DA. What is new in Rome IV. J Neurogastroenterol Motil. 2017 Apr 30;23(2):151- 163

  8. 8.Thompson WG. Gender differences in irritable bowel symptoms. Eur J Gastroenterol Hepatol. 1997 Mar;9(3):299-302

  9. 9.Thompson WG, Longstreth G, Drossman DA, Heaton K, Irvine EJ, Muller-Lissner S. Gut. Functional bowel disorders and functional abdominal pain. 1999 Sep;45(Suppl 2):II43-II47

  10. 10.Canderella MP, Azpiroz F, Malagelada JR. Antrofundic dysfunctions in functional dispepsia. Gastroenterology. 2003 May;124(5):1220-9

  11. 11.Páramo-Hernández DB. Bloating y distension abdominal: ¿Solamente gas? Una mirada hacia su fisiopatología. Rev colomb gastroenterol. 2011 Dec;26(4):269-75 12.Agrawal A, Whorwell PJ. Review article: abdominal bloating and distension in functional gastrointestinal disorders – epidemiology and exploration of possible mechanisms. Aliment Pharmacol Ther. 2008 Jan 1;27(1):2-10

  12. 13.Kamboj AK, Oxentenko AS. Workup and management of bloating. Clin Gastroenterol Hepatol. 2018 Jul;16(7):1030-33

  13. 14.Malagelada JR, Accarino A, Azpiroz F. Bloating and abdominal distension: Old misconceptions and current knowledge. Am J Gastroenterol. 2017 Aug;112(8):1221-31

  14. 15.Burri E, Barba E, Huaman JW, Cisternas D, Accarino A, Soldevilla A, et al. Mechanisms of postprandial abdominal bloating and distension in functional dyspepsia. Gut. 2014 Mar;63(3):395-400.

  15. 16.Iovino P, Bucci C, Tremolaterra F, Santonicola A, Chiarioni G. Bloating and functional gastrointestinal disorders: Where are we and where are wegoing? World JG astroenterol. 2014 Oct 21;20(39):14407-19

  16. 17.Rabago RE, Bonilla-Ramos A, Escamilla-Diego E, Fossado-Gayosso M, Higuera-De la Tijera MF, Schmulson Wasserman MJ. Tu1629-Pictograms are more effective than verbal descriptor to assess the presence of bloating and distension. Gastroenterology. 2018 May;154(6) Suppl 1:S974.

  17. 18.Rubio-Tapia A, Hill ID, Kelly CP, Calderwood AH, Murray JA. ACG clinical guidelines: diagnosis and management of celiac disease. Am J Gastroenterol. 2013 May;108(5):656–676;quiz 677

  18. 19.Ford AC, Spiegel BM, Talley NJ, Moayyedi P. Small intestinal bacterial overgrowth in irritable bowel syndrome: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2009 Dec;7(12):1279-86

  19. 20.Srivastava D, Ghoshal U, Mittal RD, and Ghoshal UC. Associations between IL-1RA polymorphisms and small intestinal bacterial overgrowth among patients with irritable bowel syndrome from India. J Neurogastroenterol Motil 2014 Oct;26(10):1408-16

  20. 21.Choi CH, Chang SK. Role of small intestinal bacterial overgrowth in functional gastrointestinal disorders. J Neurogastroenterol Motil. 2016 Jan 31;22(1):3-5

  21. 22.Saad RJ, Chey WD. Breath testing for small intestinal bacterial overgrowth: maximizing test accuracy. Clin Gastroenterol Hepatol. 2014 Dec;12(12):1964-72

  22. 23.Krajicek EJ, Hansel SL. Small intestinal bacterial overgrowth: A primary care review. Mayo Clin Proc. 2016 Dec;91(12):1828-33

  23. 24.Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology. 2006 Apr;130(5):1480–91

  24. 25.Goshal UC, Srivastava D. Irritable bowel syndrome and small intestinal bacterial overg rowth: meaningful association or unnecessary hype. World J Gastroenterol. 2014 Mar 14;20(10):2482-91

  25. 26.Halmos EP, Power VA, Shepherd SJ, Gibson PR, Muir JG. A diet low in FODMAPs reduces symptomsofirri table bowel syndrome. Gastroenterology. 2014 Jan;146(1):67–75

  26. 27.Muir JG, Gibson PR. Clinical insights: Irritable bowel syndrome: Diagnosis and management: Manipulating dietary carbohydrates to treat irritable bowel syndrome [Internet]. Londres: Future Medicine Ltd 2013[citado 2018 Oct]. Disponible: https://doi.org/10.2217/ebo.13.493

  27. 28.Dainese R, Serra J, Azpiroz F, Malagelada JR. Influence of body posture on intestinal transit of gas. Gut. 2003 Jul;52(7):971–4

  28. 29.Villoria A, Serra J, Azpiroz F, Malagelada JR. Physical activity and intestinal gas clearance in patients with bloating. Am J Gastroenterol. 2006 Nov;101(11):2552–7

  29. 30.Marshal JK, Thabane M, Garg AX, Clark WF, Salvador i M, Collins SM. Incidence and epidemiology of irritable bowel syndrome after a large waterborne outbreak of bacterial dysentery. Gastroenterology. 2006 Aug;131(2):445–50

  30. 31.Lin HC. Small intestinal bacterial overgrowth: a framework for understanding irritable bowel syndrome. JAMA. 2004 Aug 18;292(7):852–8

  31. 32.Pimentel M, Lembo A, Chey WD, Zakko S, Ringel Y, Yu J, et al. Rifaximin therapy for patients with irritable bowel syndrome without constipation. N Engl J Med. 2011 Jan 6;364(1):22-32

  32. 33.Bures J, Cyrany J, Kohoutova D, Förstl M, Rejchrt S, Kvetina J, et al. Small intestinal bacterial overgrowth syndrome. World J Gastroenterol. 2010 Jun 28;16(24):2978-90

  33. 34.Brener DM, Moeller MJ, Chey WD, Schoenfeld PS. The utility of probiotics in the treatment of irritable bowel syndrome: a systematic review. Am J Gastroenterol. 2009 Apr; 104(4):1033-49

  34. 35.Kim HJ, Vázquez-Roque MI, Camilleri M, Stephens D, Burton DD, Baxter K, et al. A randomized controlled trial of a probiotic combination VSL# 3 and placebo in irritable bowel syndrome with bloating. Neurogastroenterol Motil 2005 Oct;17(5):687- 96

  35. 36.Azpiroz F, Barba E, Mego M, et al. Metabolic adaptation of colonic microbiota to diet . United Eur Gastroenterol J. 2014;2(5S):A436

  36. 37.Accarino A, Perez F, Azpiroz F, Quiroga S, Malagelada JR. Intestinal gas and bloating: effect of prokinetic stimulation. Am J Gastroenterol. 2008 Aug;103(8):2036-42

  37. 38.Quigley EM, Tack J, Chey WD, Rao SS, Fortea J, Falques M, et al. Randomised clinical trials: linaclotide phase 3 studies in IBS-C - A prespecified further analysis based on European Medicines Agency-specified endpoints. Aliment Pharmacol Ther.

  38. 39.Poynard T, Regimbeau C, Benhamou Y. Metaanalysis of smooth muscle relaxants in the treatment of irritable bowel syndrome. Aliment Pharmacol Ther. 2001 Mar;15(3):355-61

  39. 40.Lea R, Houghton LA, Calvert EL, Larder S, Gonsalkorale WM, Whelan V, et al. Gut-focused hypnotherapy normalizes disordered rectal sensitivity in patients with irritable bowel syndrome. Aliment Pharmacol Ther. 2003 Mar;17(5):635-42

  40. 41.Whorwell PJ, Prior A, Faragher EB. Controlled trial of hypnotherapy in the treatment of severe refractory irritable bowel syndrome. Lancet. 1984 Dec;2(8414):1232-4

  41. 42.Gonsalkorale WM, Miller V, Afzal A, Whorwell PJ. Long term benefits of hypnotherapy for irritable bowel syndrome. Gut. 2003 Nov;52(11):1623-9

  42. 43.Barba E, Accarino A, Azpiroz F. Correction of abdominal distention by biofeedback-guided control of abdominothoracic muscular activity in a randomized, placebo-controlled trial. Clin Gastroenterol Hepatol. 2017 Dec;15(12), 1922-29

  43. 44.Kamm MA, Dudding TC, Melenhorst J, Jarrett M, Wang Z, Buntzen S, et al. Sacral nerve stimulation for intractable constipation. Gut. 2010 Mar;59(3):333- 40 45.Kenefick NJ, Vaizey CJ, Cohen CR, Nicholls RJ, Kamm MA. Double-blind placebo-controlled crossover study of sacral nerve stimulation for idiopathic constipation . Br JSurg. 2002 Dec;89(12):1570-1

  44. 46.Fassov JL, Lundby L, Laurberg S, Buntzen S, Krogh K. A randomized, controlled, crossover study of sacral ner ve stimulation for irritable bowel syndrome. Ann Surg. 2014 Jul;260(1):31-6




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