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Abdominal Bloating


Presentation

  • We present a case of amyloid light-chain amyloidosis with occult plasma cell dyscrasia, with the rare initial presentation of gastroparesis.[ncbi.nlm.nih.gov]
  • Similarly, older age (OR, 1.4; CI: 1.2, 1.7), chronic constipation (OR, 2.0; CI: 1.2, 3.2) and visible distention (OR, 3.0; CI: 1.8, 4.9) had greater odds of presenting for bloating or distention compared with presenting for other GI symptoms; somatic[ncbi.nlm.nih.gov]
  • ., passage of flatus), which are present in a subgroup of these patients, might be associated with carbohydrate malabsorption.[ncbi.nlm.nih.gov]
  • CONCLUSIONS: Those patients with a low level of breath hydrogen excretion after lactulose ingestion presented with significantly greater abdominal bloating than those with a high level of breath hydrogen excretion.[ncbi.nlm.nih.gov]
  • Digestive enzymes may help optimize digestive function, especially when pancreatic insufficiency is present.[evitamins.com]
Low Diaphragm
  • Although the cause of functional bloating remains unknown, old explanations such as a low diaphragm, exaggerated lumbar lordosis, and psychiatric problems have been disproved.[ncbi.nlm.nih.gov]
Constipation
  • BACKGROUND: Abdominal bloating is a common and bothersome symptom of chronic idiopathic constipation.[ncbi.nlm.nih.gov]
  • Forty-eight percent of patients also showed distention beyond the 90% control range, with this being most prominent in IBS-constipation. Bloating correlated strongly only with distention in IBS-constipation (r or 0.48; P or .02).[ncbi.nlm.nih.gov]
  • Relieving constipation might help distension, but the treatment of bloating may need more complex approaches involving sensory modulation.[ncbi.nlm.nih.gov]
  • They are not more likely to have constipation, irritable bowel syndrome or obesity than patients whose primary complaint is something other than bloating.[ncbi.nlm.nih.gov]
  • RESULTS: Of the 89 studies reviewed, 18% evaluated patients with functional dyspepsia, 61% with irritable bowel syndrome (IBS), 10% with chronic constipation and 10% with other FGIDs.[ncbi.nlm.nih.gov]
Increased Abdominal Girth
  • The small volume of retained feces is not sufficient to increase abdominal girth. The problem seems to be “upstream.”[ncbi.nlm.nih.gov]

Workup

  • I would highly recommend you consider being seen by a gastroenterologist who will do a thorough workup looking for the real reason for your symptoms. Dr.[realself.com]
  • Increased perception and sensitivity to what is happening in the digestive tract Increased curvature of the lumbar region of the spine (lumbar lordosis), which decreases the capacity of the abdomen to hold gas These tests include: Stool analysis Blood workup[iffgd.org]

Treatment

  • Conventional treatment for SIBO is typically focused on antibiotics to eradicate the bacterial overgrowth.[ncbi.nlm.nih.gov]
  • AIM: To review the treatment trials for abdominal bloating and distension. METHODS: A literature review in Medline for English-language publications through February 2010 of randomised, controlled treatment trials in adults.[ncbi.nlm.nih.gov]
  • No treatment is of proven benefit, but treatment by weight loss, exercise, and prokinetics should be studied.[ncbi.nlm.nih.gov]
  • METHODS: Randomized double-blind placebo-controlled trial consisting of three 10-day phases: baseline (phase 1), treatment with rifaximin 400 mg b.i.d. or placebo (phase 2), and post-treatment period (phase 3).[ncbi.nlm.nih.gov]
  • Treatment options are currently rather limited but include dietary changes, pharmacological approaches, probiotics and hypnotherapy.[ncbi.nlm.nih.gov]

Etiology

  • 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.[ncbi.nlm.nih.gov]
  • Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'.[icd10data.com]
  • Etiology To label a symptom “functional” begs the question, “Why does it occur?” There have been many suggestions ( Table 1 ).[ncbi.nlm.nih.gov]

Epidemiology

  • This review examines the relationship between the symptom of bloating and the physical sign of abdominal distension, as well as examining the epidemiology, pathophysiology and treatment options available for this debilitating aspect of the functional[ncbi.nlm.nih.gov]
  • BACKGROUND: The epidemiology of Functional abdominal bloating (FAB) and its impact on health-related quality of life (HRQoL) in Chinese people remains unclear.[ncbi.nlm.nih.gov]
  • AIM: To conduct a systematic, evidence-based review of the epidemiology and pathophysiology of abdominal bloating and its relationship to distension.[ncbi.nlm.nih.gov]
  • Epidemiological data distinguishing visible distention from bloating are not available.[ncbi.nlm.nih.gov]
  • Comorbidity of gastrointestinal complaints, depression, and anxiety in the Epidemiologic Catchment Area (ECA) Study. American Journal of Medicine . 1992; 92 (supplement 1A):S26–S30. [ PubMed ] 34. Sullivan SN, Wong C.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • 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.[ncbi.nlm.nih.gov]
  • Pathophysiological mechanisms explored include psychological factors, intestinal gas accumulation, fluid retention, food intolerance and malabsorption of sugars, weakness of abdominal musculature, and altered sensorimotor function.[ncbi.nlm.nih.gov]
  • AIM: To conduct a systematic, evidence-based review of the epidemiology and pathophysiology of abdominal bloating and its relationship to distension.[ncbi.nlm.nih.gov]
  • It is now seems probable that the pathophysiology of bloating and distension are subtly different with the former having a sensory component whereas mechanical factors, such as disordered abdominal accommodation, contribute more to the latter.[ncbi.nlm.nih.gov]
  • The pathophysiology of these two phenomena is somewhat different and it is now recognised that a whole variety of overlapping mechanisms are involved.[ncbi.nlm.nih.gov]

Prevention

  • Home Remedies and Prevention Tips For Abdominal Bloating 3D Video Tips to Prevent Abdominal Bloating Avoid smoking. Stay away from chewing gums and carbonated drinks. Avoid foods with high levels of fructose or sorbitol.[epainassist.com]
  • RESULTS: In healthy subjects, duodenal lipid infusion produced gas retention (409 (68) ml) which was prevented by rectal distension (90 (90) ml; p CONCLUSION: Failure of distension related reflexes impairs intestinal gas propulsion and clearance in patients[ncbi.nlm.nih.gov]
  • Prevention The best way to prevent gas that is caused by foods is—predictably—to avoid those foods that contribute to intestinal gas.[ibdcrohns.about.com]
  • Consider preventative care such as seasonal colon cleansing. Implement these changes gradually, tackling only one or two at a time.[puristat.com]
  • To avoid future occurrences, there are treatment options, but the majority are preventive in nature.[dhccenter.com]

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