GASTROENTEROLOGY ARTICLE OF THE WEEK
January 12, 2006
Azpiroz F, Malagelada JR. Abdominal bloating. Gastroenterology 2005;129:1060-78.
1. Bloating
a. is reported by 96% of IBS patient and is the most severe symptom in 60%
b. Bloating can be a component of IBS-D, in this group exclusion of fructose & lactose
malabsorption as well as celiac sprue is important.
c. In most IBS patients who complain of bloating, the amount of intestinal gas is not increased
d. In approximately 40% of females, bloating typically gets worse before and during the
menstrual period
2. Products that have been proven to be effective in treating bloating include
a. peppermint oil
b. probiotics
c. oral activated charcoal
d. digesive enzyme preparations
True or False
3. This article was severely bloated with useless information.
4. Malabsorption or maldigestion of nutrients in normal individuals is more likely to lead to flatulence rather than bloating as most normal individuals can expel large amounts of gas without perception of bloating.
5. In many patients with IBS, bloating associated with increased in abdominal girth becomes progressively worse during the day, it is most common in IBS-C, and often produces visible abdominal distention.
6. Sudden onset bloating bloating with rapid resolution usually indicates a problem related to the muscular activity of the abdominal wall.
7. The normal amount of gas in the GI tract is 100-200 ml at any given time.
8. Oxygen accounts for most of the gas in flatus during the fasting state.
9. Fiber overload is a common cause of bloating in IBS patients, often without associated flatulence.
10. In most patients with complaints of bloating, intestinal gas is retained because of impaired small intestinal propulsion, colonic transit is usually normal.
11. Post pandrial bloating is typical in patients with dyspepsia and in binge eaters.
12. Abdominal bloating in patients with dyspepsia usually signals gastric outlet obstruction or gastric emptying disorder.
13. Flatulent patients must assign and “flatus price” to each type of food and decide if they want to pay the “flatus price” to eat it (in most cases the partner pays the flatus price as well).