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

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.
Gastroenterology 2005 Sep
PMID:Abdominal bloating. 1614 43

Celiac disease develops from an autoimmune response to specific dietary grains that contain gluten. Diagnosis can be made based on the classical presentation of diarrhea, fatty stools, and abdominal bloating and cramping, as well as the presence of specific serum antibodies. In addition, gluten ingestion has increasingly been found to be associated with other conditions not usually correlated with gluten intolerance. The subsequent diversity of the clinical presentation in these cases can complicate decision-making and delay treatment initiation in conditions such as ataxia, headaches, arthritis, neuropathy, type 1 diabetes mellitus, and others. This review explores the etiology and pathology of celiac disease, presents support for the relationship between gluten and other diseases, and provides effective screening and treatment protocols.
Altern Med Rev 2005 Sep
PMID:Celiac disease and gluten-associated diseases. 1616 73

Research was conducted to determine the effects of level of supplementation with quebracho condensed tannins (CT) on in vitro ruminal fluid gas production, in vivo ruminal fluid protein fractions, bloat dynamics, and ADG of steers grazing winter wheat. Two experiments were conducted to 1) enumerate the effect of ruminal fluid from steers fed quebracho CT (0, 1, and 2% CT/kg of DMI) on in vitro gas and methane production from minced fresh wheat forage; and 2) quantify the influence of CT supplementation on ruminal protein characteristics, biofilm complexes, bloat potential, and ADG of steers grazing wheat pasture. Eighteen ruminally cannulated steers (386 +/- 36 kg of BW) were randomly allocated to 1 of 3 treatments that included a control (water infusion) and 2 CT treatment levels (1 or 2% CT/kg of DMI). Treatments were administered daily (63 d) through the rumen cannula as pre-mixes with warm water (approximately 30 degrees C). Rumen contents were collected 2 h postinfusion (at 1030 to 1130) on d 0, 20, 40, 50, and 60. Bloat was visually scored daily for 5 d each wk. In Exp. 1, supplementation of CT decreased the rate of in vitro gas production in a dose-dependent response. In Exp. 2, ADG increased (P < 0.04) at both levels of CT supplementation. Mean bloat score across stage of growth and replicates decreased linearly with increasing CT supplementation; bloat scores were greater (P < 0.001) for the vegetative than for the reproductive stage of plant growth. Biofilm production and rumen fluid protein fractions varied among CT treatments and stage of growth. Addition of CT reduced the severity of bloat, principally through reducing microbial activities, biofilm production, and ruminal gas production. Quebracho CT is potentially a value-added supplement that can decrease the impacts of frothy bloat and increase BW gains in stocker cattle-wheat systems.
J Anim Sci 2006 Sep
PMID:Effects of condensed tannins supplementation level on weight gain and in vitro and in vivo bloat precursors in steers grazing winter wheat. 1690 60

A colony of frogs experienced excessive mortality due to glomerulonephritis. The presenting symptom in all cases was bloating due to hydrocoelom and anasarca. Mycobacteria sp was suspected to be a source of chronic antigenic stimulation that resulted in the glomerulonephritis. The prognosis was grave once symptoms appeared. Histopathology from some of the affected frogs is described, and mycobacterial disease in amphibians is discussed.
Vet Clin North Am Exot Anim Pract 2006 Sep
PMID:Glomerulonephritis and anasarca in a colony of frogs. 1693 81

Gastrointestinal (GI) dysfunction is the most common non-motor symptom of Parkinson's disease (PD). Symptoms of GI dysmotility include early satiety and nausea from delayed gastric emptying, bloating from poor small bowel coordination, and constipation and defecatory dysfunction from impaired colonic transit. Understanding the pathophysiology and treatment of these symptoms in PD patients has been hampered by the lack of investigation into GI symptoms and pathology in PD animal models. We report that the prototypical parkinsonian neurotoxin, MPTP (1-methyl 4-phenyl 1,2,3,6-tetrahydropyridine), is a selective dopamine neuron toxin in the enteric nervous system (ENS). When examined 10 days after treatment, there was a 40% reduction of dopamine neurons in the ENS of C57Bl/6 mice administered MPTP (60 mg/kg). There were no differences in the density of cholinergic or nitric oxide neurons. Electrophysiological recording of neural-mediated muscle contraction in isolated colon from MPTP-treated animals confirmed a relaxation defect associated with dopaminergic degeneration. Behaviorally, MPTP induced a transient increase in colon motility, but no changes in gastric emptying or small intestine transit. These results provide the first comprehensive assessment of gastrointestinal pathophysiology in an animal model of PD. They provide insight into the impact of dopaminergic dysfunction on gastrointestinal motility and a benchmark for assessment of other PD model systems.
Exp Neurol 2007 Sep
PMID:Loss of enteric dopaminergic neurons and associated changes in colon motility in an MPTP mouse model of Parkinson's disease. 1827 53

Most papers report excellent results of laparoscopic fundoplication but with relatively short follow-up. Only few studies have a follow-up longer than 5 years. We prospectively collected data of 399 consecutive patients with gastroesophageal reflux disease (GERD) or large paraesophageal/mixed hiatal hernia who underwent laparoscopic fundoplication between January 1992 and June 2005. Preoperative workup included symptoms questionnaire, videoesophagogram, upper endoscopy, manometry, and pH-metry. Postoperative clinical/functional studies were performed at 1, 6, 12 months, and thereafter every other year. Patients were divided into four groups: GERD with nonerosive esophagitis, erosive esophagitis, Barrett's esophagus, and large paraesophageal/mixed hiatal hernia. Surgical failures were considered as follows: (1) recurrence of GERD symptoms or abnormal 24-h pH monitoring; (2) recurrence of endoscopic esophagitis; (3) recurrence of hiatal hernia/slipped fundoplication on endoscopy/barium swallow; (4) postoperative onset of dysphagia; (5) postoperative onset of gas bloating. One hundred and forty-five patients (87 M:58 F) were operated between January 1992 and June 1999: 80 nonerosive esophagitis, 29 erosive esophagitis, 17 Barrett's esophagus, and 19 large paraesophageal/mixed hiatal hernias. At a median follow-up of 97 months, the success rate was 74% for surgery only and 86% for primary surgery and 'complementary' treatments (21 patients: 13 redo surgery and eight endoscopic dilations). Dysphagia and recurrence of reflux were the most frequent causes of failure for nonerosive esophagitis patients; recurrence of hernia was prevalent among patients with large paraesophageal/mixed hiatal hernia. Gas bloating (causing failure) was reported by nonerosive esophagitis patients only. At last follow-up, 115 patients were off 'proton-pump inhibitors'; 30 were still on medications (eight for causes unrelated to GERD). Conclusion confirms that laparoscopic fundoplication provides effective, long-term treatment of gastroesophageal reflux disease. Hernia recurrence and dysphagia are its weak points.
J Gastrointest Surg 2007 Sep
PMID:Long-term results (6-10 years) of laparoscopic fundoplication. 1761 38

Gastroparesis is a disorder of the stomach caused by delayed gastric emptying in the absence of mechanical obstruction. Symptoms of gastroparesis include nausea, vomiting, early satiety, bloating, and abdominal discomfort. Gastroparesis has been described as a complication of several malignancies, including gastric, pancreatic, gallbladder, esophageal, and lung cancers, as well as leiomyosarcoma. The prevalence of malignant gastroparesis (MG) is unknown, and this entity is widely underrecognized and undertreated. Diabetes mellitus is the most common identifiable cause of benign gastroparesis, ie, gastroparesis occurring in the absence of an underlying malignant pathology. In the setting of malignancy, gastroparesis may result from the cancer itself or may be a complication of its treatment with such modalities as surgery, radiation therapy, or chemotherapy. Coexisting conditions, including diabetes, hypothyroidism, and neurologic diseases, may further exacerbate MG. The pathogenesis of MG is not clearly understood at present. However, mechanisms suggested in the literature include postvagotomy syndrome, malignant infiltration of the autonomic nervous system, and paraneoplastic dysmotility with autoantibody-mediated destruction of the enteric nervous system (the interstitial cells of Cajal, also called the intrinsic pacemaker of the gastrointestinal tract, or the myenteric plexus). Appropriate treatment of MG may help to avoid serious consequences, such as cancer cachexia, intolerance of oral anticancer agents, dehydration, and hospitalization. In this article, we will describe our institutional experience with MG and will provide a concise review of the literature. Guidelines for management will be suggested.
J Support Oncol 2007 Sep
PMID:Malignant gastroparesis: pathogenesis and management of an underrecognized disorder. 1794 45

Ovarian cancer is usually diagnosed after it has spread and is difficult to cure. Most of attempts to identify early symptoms have lacked control group or have been based on interviews. We examined early symptoms of ovarian cancer in young women and compared with a matched control group. Symptoms recorded in medical files of 100 women aged 15-35 years with ovarian cancer who were referred to Vali-Asr hospital between 1995 and 2005. Symptoms of cases were compared with 100 matched controls during 2 years before diagnosis. More cases (95%) than controls (28%) complained of at least one symptom up to 2 years before diagnosis, most of these symptoms were abdominal. Others included urinary symptoms, infertility and abnormal vaginal bleeding. The most common symptoms among cases were: unusual abdominal or lower back pain 52%, unusual bloating, fullness and pressure in the abdomen 37%, gastro-intestinal problems 36%. In total, 11%, 3% and 12% of controls reported these symptoms respectively, resulting in odds ratios of 8.7, 18.9 and 4.1 respectively for these symptoms. Unusual abdominal or lower back pain, fullness and pressure, gastrointestinal, urinary problems and infertility should make women and physicians more aware of changes associated with ovarian cancer.
Eur J Cancer Care (Engl) 2008 Sep
PMID:Symptoms of ovarian cancer in young patients 2 years before diagnosis, a case-control study. 1853 13

Functional bowel disorders (FBDs) are common disorders that are characterized by various combinations of abdominal pain and/or discomfort, bloating and changes in bowel habits. At present, diagnosing FBDs often incurs considerable health-care costs, partly because unnecessary investigations are performed. Patients are currently diagnosed as having an FBD on the basis of a combination of typical symptoms, normal physical examination and the absence of alarm features indicative of an organic gastrointestinal disease. Basic laboratory investigations, such as a complete blood count, measurement of the erythrocyte sedimentation rate and serological tests for celiac disease, are useful in the initial evaluation. No further investigations are needed for most patients who have typical symptoms and no alarm symptoms. The most important alarm symptoms include signs of gastrointestinal bleeding, symptom onset above 50 years of age, a family history of colorectal cancer, documented weight loss and nocturnal symptoms. The presence of alarm symptoms obviously does not exclude an FBD, but further investigation is needed before confirmation of the diagnosis. For patients with predominant and severe diarrhea, a more thorough diagnostic work-up should normally be considered, including colonoscopy with colonic biopsies and a test for bile-acid malabsorption.
Nat Clin Pract Gastroenterol Hepatol 2008 Sep
PMID:Efficient diagnosis of suspected functional bowel disorders. 1867 89

Opioid analgesics are a cornerstone of pain therapy in the hospice and palliative care population. However, opioid-induced bowel dysfunction (OBD) is a commonly associated condition that frequently compromises the usefulness of these agents. Although its most common and debilitating symptom is constipation, the impact of OBD extends beyond constipation to encompass a myriad of gastrointestinal (GI) signs and symptoms, ranging from decreased gastric emptying and reflux to abdominal pain, cramping, bloating, nausea, and vomiting. Even after aggressive therapies to improve bowel function have been implemented, many patients continue to experience symptoms of OBD. To avoid these unwanted effects, some even choose to decrease or discontinue therapy with opioid analgesics, and experience inadequate pain control. The net result of OBD is a seriously negative impact on quality of life (QOL). For these reasons, it is important that palliative care practitioners have an adequate understanding of normal GI function and the underlying mechanisms responsible for OBD, the burden of OBD in the context of appropriate and effective pain management, and the benefits provided by effective pharmacotherapy. Several real-world cases are discussed to illustrate the application of optimal symptom management and the use of strategies that minimize the effects of OBD and improve patient QOL.
J Palliat Med 2008 Sep
PMID:Palliative care and pain: new strategies for managing opioid bowel dysfunction. 1880 Sep 14


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