Bloating, as a symptom and abdominal distension, as a sign, are both common functional-type complaints and challenging to manage effectively.
Individual patients may weight differently the impact of bloating and distension on their well-being.
Complaints may range from chronic highly distressing pain to simply annoying and unfashionable protrusion of the abdomen.
Dr Juan Malagelada and colleagues from Spain avoided mishaps, organic bloating, and distension should always be considered first and appropriated assessed.
|Therapeutic resources focussed on pathogenetic mechanism including dietary modification|
|American Journal of Gastroenterology|
The research team report that functional bloating and distension often present in association with other manifestations of irritable bowel syndrome or functional dyspepsia, and in that context patients tend to regard them as most troublesome.
The team report that a mechanism-based management bloating and distension should be ideal but elucidating key operational mechanisms in individual patients is not always feasible.
Some clues may be gathered through a detailed dietary history, by assessing bowel movement frequency and stool consistency and special imaging technique to measure abdominal shape during episodes of distension.
In severe, protracted cases the researchers found that it may be appropriate to refer the patient to a specialized center where motility, visceral sensitivity, and abdominal muscle activity in response to intraluminal stimuli may be measured.
Dr Malagelada's team concludes, "Therapeutic resources focussed upon presumed or demonstrated pathogenetic mechanism include dietary modification, microbiome modulation, promoting gas evacuation, attenuating visceral perception, and controlling abdominal wall muscle activity via biofeedback."