Patients with abdominal bloating and distension exhibit impaired transit of intestinal gas which may lead to excessive gas retention and symptoms.
Furthermore, it has previously been shown that intestinal gas transit is normally accelerated by rectal distension.
Dr Azpiroz and colleagues from Barcelona, Spain hypothesized that in patients with functional bloating this modulatory mechanism fails and impairs gas transit.
The investigators compared, by paired studies, the effect of rectal versus sham distension on intestinal gas transit in 12 healthy subjects and 8 patients with abdominal bloating.
|Duodenal lipid infusion produced gas retention which was prevented by rectal distension|
Clinicians infused gas into the jejunum (12 ml/min) for 3 hours with simultaneous perfusion of lipids into the duodenum (Intralipid 1 kcal/min) while measuring evacuation of gas per rectum.
The researchers found that in healthy subjects, duodenal lipid infusion produced gas retention (409 (68) ml) which was prevented by rectal distension.
In contrast, the research team noted that rectal distension in patients with abdominal bloating failed to reduce lipid induced gas retention (771 (217) ml retention during rectal distension vs 730 (183) ml during sham distension.
Dr Azpiroz concluded, "Failure of distension related reflexes impairs intestinal gas propulsion and clearance in patients with abdominal bloating."