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Query: UMLS:C1291077 (bloating)
 1,674 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Our aim was to evaluate the response to intraluminal gas in irritable bowel syndrome and to determine whether this response was consequent upon disordered motility or altered perception. We evaluated 10 patients who satisfied the clinical criteria for the diagnosis of irritable bowel syndrome and 10 healthy controls. An eight-lumen perfused catheter assembly was positioned to monitor motor activity in the duodenum and proximal jejunum; a separate side port in the distal duodenum permitted gas infusion. Subjects recorded symptoms of abdominal pain, bloating, and nausea throughout the study, using a visual analog scale. Following an overnight fast and a 60-min basal recording period in the fasted state, subjects ate a standard meal; 60 min later, "sham" gas was administered for 20 min, followed by the actual infusion of nitrogen gas at 40 ml/min. Subjects were randomized to receive atropine (7 micrograms/kg) or placebo intravenously during the period of actual gas infusion. Patients with irritable bowel syndrome described more pain (score, mean +/- SE, control versus irritable bowel: 0.22 +/- 0.16 vs 1.65 +/- 0.5, P < 0.01) and nausea (0.25 +/- 0.21 vs 1.45 +/- 0.64, P < 0.04) during sham gas; motility indices were similar in both groups. During active gas, irritable bowel syndrome patients reported more pain (0.40 +/- 0.39 vs 2.94 +/- 1.16, P < 0.03); motility indices at all sites were similar in both groups. Symptom severity in irritable bowel syndrome subjects randomized to receive atropine was similar to control subjects during active gas infusion; motility indices were similar.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Response to intraluminal gas in irritable bowel syndrome. Motility versus perception. 778 64

Excessive spontaneous swallowing has been associated with a variety of common gastrointestinal symptoms including abdominal pain, heartburn, and bloating and may contribute to disorders such as hiatus hernia, duodenal ulcer, and irritable bowel syndrome. The present study investigated the hypothesis that changes in emotional state alter spontaneous swallowing rate. Subjects were 38 generally healthy undergraduates assigned to either a pleasant low arousal, neutral, or aversive high arousal condition. Each experimental session was divided into 30-min baseline and arousal manipulation periods. Spontaneous swallowing rate increased significantly with emotional arousal: for low, neutral, and high arousal groups, means were 7.9 +/- 1.9 (SE), 15.8 +/- 2.4, and 23.7 +/- 3.6 swallows/30 min, respectively. Other physiological and self-report measures, used to check the effectiveness of the arousal manipulation, varied appropriately with experimental procedures. These results indicate that changes in emotional state alter spontaneous swallowing rate in generally healthy individuals. Further research with patients is needed to establish whether stress-induced increases in swallowing rate produce or exacerbate clinically significant gastrointestinal symptomatology.
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PMID:Spontaneous swallowing rate and emotional state. Possible mechanism for stress-related gastrointestinal disorders. 785 Nov 90

Ten to 25% of healthy persons have bloating at some time or other. It is very common in those with the irritable bowel syndrome, constipation, or anorexia nervosa. Although the cause of functional bloating remains unknown, old explanations such as a low diaphragm, exaggerated lumbar lordosis, and psychiatric problems have been disproved. New suggestions on its etiology include recent weight gain, weak abdominal muscles, and retained fluid in loops of small intestine. No treatment is of proven benefit, but treatment by weight loss, exercise, and prokinetics should be studied.
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PMID:Functional abdominal bloating. 793 Apr 28

In the irritable bowel syndrome gastrointestinal tract motility is disturbed from the esophagus to the colon, causing pain and altered function. When colonic motility is abnormal, the patient can experience either constipation or diarrhea in addition to abdominal pain and bloating. In constipated patients the postprandial colonic motility can increase normally after eating or the colon can remain motionless. Generally propagating contractions are absent in patients with constipation predominant irritable bowel syndrome. Propagating contractions are increased in frequency in patients with diarrhea, although the phasic contractions are decreased. Questionnaires discriminate between patients with structural disease such as ulcerative colitis and patients with functional disease, however they cannot differentiate between the different subgroups of patients with constipation predominant irritable bowel syndrome. Treatment strategies are beginning to focus on the underlying pathophysiologic abnormality.
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PMID:Current concepts in the management of the irritable bowel syndrome. 799 65

The prevalence of lactose maldigestion is lowest in Scandinavia and Northwest Europe (3-8%) and close to 100% in most of Southeast Asia. In Europe the frequency increases in the southern and eastern directions, reaching 70% in southern Italy and Turkey. There is also a high prevalence of lactose maldigestion in the people of Africa with the exception of cattle-raising nomads. Lactose maldigestion causes uncharacteristic abdominal symptoms such as bloating, borborygmus, colic, flatulence, and diarrhea. The degree of discomfort depends on the amount of lactose consumed, but also on an individual sensitivity to lactose. The symptoms of irritable bowel syndrome (IBS) and lactose maldigestion are similar. Consequently, most investigations indicate an increased frequency of lactose maldigestion in patients suffering from IBS. Recurrent abdominal pain (RAP) in children corresponds to IBS in adults. Lactose maldigestion is a frequent cause of RAP in regions with a high prevalence of lactose maldigestion in early childhood. Diffuse small-intestinal damage in celiac disease or kwashiorkor leads to a proportional decrease of all disaccharidase activities, with the most pronounced being decrease of lactase. The consumption of milk may then cause abdominal discomfort and increased diarrhea. Several investigations have indicated an increased frequency of lactose maldigestion in patients with osteoporosis. A connection between lactose maldigestion and decreased absorption of calcium has not been proven, however. The increased tendency toward osteoporosis is more likely caused by a lower calcium intake because of milk intolerance. Milk and dairy products with reduced lactose content are better tolerated by patients with lactose maldigestion.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The clinical significance of disaccharide maldigestion. 811 58

Because unsubstantiated beliefs link hysterectomy and cholecystectomy with bowel function, this study examined all the women who had had these operations in a defined population (79 and 37 respectively, out of 1058) with respect to bowel habits, irritable bowel syndrome symptoms, and whole gut transit time calculated from records of three defecations. Compared with unoperated controls, women after hysterectomy were more likely to consider themselves constipated; they also strained more and admitted more often to bloating and feelings of incomplete evacuation. Their stools tended to be lumpier and, in women over 50 years, transit time was longer. When women treated by cholecystectomy were compared with women having newly discovered, asymptomatic gall stones, they more often described defecation as urgent but had no other detectable differences. In conclusion symptomatic constipation is frequent in women after hysterectomy; after cholecystectomy, bowel habit is not consistently changed but the rectum seems to be more irritable.
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PMID:Bowel function and irritable bowel symptoms after hysterectomy and cholecystectomy--a population based study. 817 64

The effects of octreotide on six normal subjects and five patients with scleroderma were investigated. Changes in intestinal motility and in plasma motilin were examined after a single injection of octreotide. Octreotide stimulated intense intestinal motor activity in normal subjects. Motility patterns in the scleroderma patients were chaotic and non-propagative, but, after octreotide was given, became well coordinated, aborally directed, and nearly as intense as in normal volunteers. Clinical responses and changes in breath hydrogen were also evaluated in the five scleroderma patients who had further treatment with octreotide at a dose of 50 micrograms/day subcutaneously for three weeks. A reduction in symptoms of abdominal pain, nausea, vomiting, and bloating was seen. Additionally, there was an improvement in bacterial overgrowth as objectively measured by breath hydrogen testing. The effects of octreotide (100 micrograms/day subcutaneously) on the perception of rectal distension were investigated in a double blind, placebo controlled study in healthy volunteers. Octreotide was shown to reduce the perception of rectal distension without affecting motor pathways or local rectal reflexes. This enhanced tolerance to volume distension seems to result from inhibition of sensory afferent pathways as shown by electroencephalographic studies showing diminished evoked spinal and cortical potentials after octreotide. In irritable bowel syndrome patients with rectal urgency, octreotide reduces rectal pressures and perception after rectal distension to near normal values.
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PMID:Octreotide in gastrointestinal motility disorders. 820 95

First, it is important to find out whether the patient is complaining of infrequent defaecation, excessive straining at defaecation, abdominal pain or bloating, a general sense of malaise attributed to constipation, soiling, or a combination of more than one symptom. Second, one must decide if there is a definable abnormality as a cause of the symptom(s). Is the colon apparently normal or is its lumen widened (megacolon)? Is the upper gut normal or is there evidence of neuropathy or myopathy? Is the ano-rectum normal or is there evidence of a weak pelvic floor, mucosal prolapse, major rectocele, an internal intussusception or solitary rectal ulcer? Is there any systemic component such as hypothyroidism, hypercalcaemia, neurological or psychiatric disorder or relevant drug therapy? Choice of treatment will depend on this clinical evaluation. The range of treatments available is: Reassurance and stop current treatment: Patients with a bowel obsession may take laxatives or rectal preparations regularly without need. Increase dietary fibre: Most cases of 'simple' constipation respond to increased dietary fibre, possibly with an added supplement of natural bran. Toilet training and altered routine of life: Young people particularly may need to recognise the call to stool and alter their daily routine to permit and encourage regular defaecation. Medicinal bulking agent: Ispaghula, methyl cellulose, concentrated wheat germ or bran, and similar preparations are useful when patients with a normal colon find it difficult to take adequate dietary fibre. These preparations increase the bulk of stool and soften its consistency. They may be useful for those patients with the constipated form of irritable bowel syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Clinical management of constipation. 823 32

Our objective was to obtain national data of the estimated prevalence, sociodemographic relationships, and health impact of persons with functional gastrointestinal disorders. We surveyed a stratified probability random sample of U.S. householders selected from a data base of a national market firm (National Family Opinion, Inc.). Questions were asked about bowel symptoms, sociodemographic associations, work absenteeism, and physician visits. The sampling frame was constructed to be demographically similar to the U.S. householder population based on geographic region, age of householder, population density, household income, and household size. Of 8250 mailings, 5430 were returned suitable for analysis (66% response). The survey assessed the prevalence of 20 functional gastrointestinal syndromes based on fulfillment of multinational diagnostic (Rome) criteria. Additional variables studied included: demographic status, work absenteeism, health care use, employment status, family income, geographic area of residence, population density, and number of persons in household. For this sample, 69% reported having at least one of 20 functional gastrointestinal syndromes in the previous three months. The symptoms were attributed to four major anatomic regions: esophageal (42%), gastroduodenal (26%), bowel (44%), and anorectal (26%), with considerable overlap. Females reported greater frequencies of globus, functional dysphagia, irritable bowel syndrome, functional constipation, functional abdominal pain, functional biliary pain and dyschezia; males reported greater frequencies of aerophagia and functional bloating. Symptom reporting, except for incontinence, declines with age, and low income is associated with greater symptom reporting. The rate of work/school absenteeism and physician visits is increased for those having a functional gastrointestinal disorder. Furthermore, the greatest rates are associated with those having gross fecal incontinence and certain more painful functional gastrointestinal disorders such as chronic abdominal pain, biliary pain, functional dyspepsia and IBS. Preliminary information on the prevalence, socio-demographic features and health impact is provided for persons who fulfill diagnostic criteria for functional gastrointestinal disorders.
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PMID:U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. 835 66

The irritable bowel syndrome (IBS) is characterized by alimentary and non-alimentary symptoms; the aim of this study was to assess the clinical value and discriminant function of non-alimentary symptoms in the irritable bowel syndrome. Alimentary and non-alimentary symptoms, estimated daily dietary fibre intakes, ability to express personal feelings, anxiety and depression ratings, and life events and difficulties inventories were compared in 128 hospital out-patients with IBS and 113 age and sex matched control subjects not seeking health care, randomly recruited from the community. Alimentary symptoms correlated closely with those non-alimentary symptoms often associated with the hyperventilation syndromes, difficulties in expressing personal feelings and anxiety, and depression ratings. Life events and difficulties, and estimated daily dietary fibre intakes did not differ significantly between patients and controls. With the exception of abdominal bloating, no significant gender differences were observed in IBS symptoms in either the IBS or control groups. The irritable bowel syndrome is one facet of a more general condition of illness behaviour which includes the hyperventilation syndrome and an inassertiveness in expressing personal feelings. Though non-alimentary symptoms did not improve diagnostic accuracy beyond that achieved by a combination of alimentary symptoms, their recognition provides alternative approaches to the management of refractory IBS.
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PMID:Non-alimentary aspects of the irritable bowel syndrome. 838 15


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