Bloating and Abdominal Distension: Clinical Approach and Management

Overview

Journal Adv Ther

Date 2019 Mar 18

PMID 30879252

Citations 13

Authors

Amir Mari

Fadi Abu Backer

Mahmud Mahamid

Hana Amara

Dan Carter

Doron Boltin

Ram Dickman

Affiliations

Soon will be listed here.

Abstract

Functional abdominal bloating and distension (FABD) are common gastrointestinal complaints, encountered on a daily basis by gastroenterologists and healthcare providers. Functional abdominal bloating is a subjective sensation that is commonly associated with an objective abdominal distension. FABD may be diagnosed as a single entity (the sole or cardinal complaint) or may overlap with other functional gastrointestinal disorders such as functional constipation, irritable bowel syndrome, and functional dyspepsia. The pathophysiology of FABD is not completely understood. Proposed underlying mechanisms include visceral hypersensitivity, behavioral induced abnormal abdominal wall-phrenic reflexes, the effect of poorly absorbed fermentable carbohydrates, and microbiome alterations. Management includes behavioral therapy, dietary interventions, microbiome modulation, and medical therapy. This review presents the current knowledge on the pathophysiology, evaluation, and management of FABD.

Citing Articles

Psychometric Evaluation of the Abdominal Bloating Social Support Scale.

Abdullah N, Kueh Y, Kuan G, Wong M, Lee Y Malays J Med Sci. 2024; 31(4):138-148.

PMID: 39247105 PMC: 11377009. DOI: 10.21315/mjms2024.31.4.11.

Functional Abdominal Bloating and Gut Microbiota: An Update.

Crucilla S, Caldart F, Michelon M, Marasco G, Costantino A Microorganisms. 2024; 12(8).

PMID: 39203511 PMC: 11357468. DOI: 10.3390/microorganisms12081669.

Functional Bowel Disorder Management in Routine Practice with Tips for Hot Topics: Expert Opinion Review.

Akyuz F, Celebi A, Dogan I, Erzin Y, Kav T, Soyturk M Turk J Gastroenterol. 2024; 35(6):423-439.

PMID: 39128123 PMC: 11232060. DOI: 10.5152/tjg.2024.24029.

Structural equation models of health behaviour, psychological well-being, symptom severity and quality of life in abdominal bloating.

Abdullah N, Kueh Y, Kuan G, Wong M, Tee V, Tengku Alang T PeerJ. 2024; 12:e17265.

PMID: 38708340 PMC: 11067892. DOI: 10.7717/peerj.17265.

Efficacy and Safety of Pea Protein and Xyloglucan Versus Simethicone in Functional Abdominal Bloating and Distension.

Petrisor D, Etropolska Z, Elenski K, Dimitrova E, Santos J Dig Dis Sci. 2023; 69(1):161-168.

PMID: 37923826 PMC: 10787906. DOI: 10.1007/s10620-023-08155-1.

References

Videlock E, Cheng V, Cremonini F . Effects of linaclotide in patients with irritable bowel syndrome with constipation or chronic constipation: a meta-analysis. Clin Gastroenterol Hepatol. 2013; 11(9):1084-1092.e3. DOI: 10.1016/j.cgh.2013.04.032. View

Agrawal A, Houghton L, Reilly B, Morris J, Whorwell P . Bloating and distension in irritable bowel syndrome: the role of gastrointestinal transit. Am J Gastroenterol. 2009; 104(8):1998-2004. DOI: 10.1038/ajg.2009.251. View

Ringel-Kulka T, Benson A, Carroll I, Kim J, Legge R, Ringel Y . Molecular characterization of the intestinal microbiota in patients with and without abdominal bloating. Am J Physiol Gastrointest Liver Physiol. 2015; 310(6):G417-26. PMC: 4796292. DOI: 10.1152/ajpgi.00044.2015. View

Moayyedi P, Ford A, Talley N, Cremonini F, Foxx-Orenstein A, Brandt L . The efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review. Gut. 2008; 59(3):325-32. DOI: 10.1136/gut.2008.167270. View

Houghton L, Lea R, Agrawal A, Agrawal A, Reilly B, Whorwell P . Relationship of abdominal bloating to distention in irritable bowel syndrome and effect of bowel habit. Gastroenterology. 2006; 131(4):1003-10. DOI: 10.1053/j.gastro.2006.07.015. View

Simren M, Barbara G, Flint H, Spiegel B, Spiller R, Vanner S . Intestinal microbiota in functional bowel disorders: a Rome foundation report. Gut. 2012; 62(1):159-76. PMC: 3551212. DOI: 10.1136/gutjnl-2012-302167. View

Rao S, Lembo A, Shiff S, Lavins B, Currie M, Jia X . A 12-week, randomized, controlled trial with a 4-week randomized withdrawal period to evaluate the efficacy and safety of linaclotide in irritable bowel syndrome with constipation. Am J Gastroenterol. 2012; 107(11):1714-24. PMC: 3504311. DOI: 10.1038/ajg.2012.255. View

Accarino A, Azpiroz F, Malagelada J . Attention and distraction: effects on gut perception. Gastroenterology. 1997; 113(2):415-22. DOI: 10.1053/gast.1997.v113.pm9247458. View

Bennet S, Ohman L, Simren M . Gut microbiota as potential orchestrators of irritable bowel syndrome. Gut Liver. 2015; 9(3):318-31. PMC: 4413965. DOI: 10.5009/gnl14344. View

10.

Tack J, Stanghellini V, Dubois D, Joseph A, Vandeplassche L, Kerstens R . Effect of prucalopride on symptoms of chronic constipation. Neurogastroenterol Motil. 2013; 26(1):21-7. PMC: 4282451. DOI: 10.1111/nmo.12217. View

11.

Ringel-Kulka T, Palsson O, Maier D, Carroll I, Galanko J, Leyer G . Probiotic bacteria Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07 versus placebo for the symptoms of bloating in patients with functional bowel disorders: a double-blind study. J Clin Gastroenterol. 2011; 45(6):518-25. PMC: 4372813. DOI: 10.1097/MCG.0b013e31820ca4d6. View

12.

Vernia P, Di Camillo M, Marinaro V, Caprilli R . Effect of predominant methanogenic flora on the outcome of lactose breath test in irritable bowel syndrome patients. Eur J Clin Nutr. 2003; 57(9):1116-9. DOI: 10.1038/sj.ejcn.1601651. View

13.

Liu J, Chen G, Yeh H, Huang C, Poon S . Enteric-coated peppermint-oil capsules in the treatment of irritable bowel syndrome: a prospective, randomized trial. J Gastroenterol. 1998; 32(6):765-8. DOI: 10.1007/BF02936952. View

14.

Serra J, Azpiroz F, Malagelada J . Modulation of gut perception in humans by spatial summation phenomena. J Physiol. 1998; 506 ( Pt 2):579-87. PMC: 2230719. DOI: 10.1111/j.1469-7793.1998.579bw.x. View

15.

Catassi G, Lionetti E, Gatti S, Catassi C . The Low FODMAP Diet: Many Question Marks for a Catchy Acronym. Nutrients. 2017; 9(3). PMC: 5372955. DOI: 10.3390/nu9030292. View

16.

Jonkers D, Stockbrugger R . Review article: Probiotics in gastrointestinal and liver diseases. Aliment Pharmacol Ther. 2008; 26 Suppl 2:133-48. DOI: 10.1111/j.1365-2036.2007.03480.x. View

17.

Lacy B, Schey R, Shiff S, Lavins B, Fox S, Jia X . Linaclotide in Chronic Idiopathic Constipation Patients with Moderate to Severe Abdominal Bloating: A Randomized, Controlled Trial. PLoS One. 2015; 10(7):e0134349. PMC: 4519259. DOI: 10.1371/journal.pone.0134349. View

18.

Lewis M, Reilly B, Houghton L, Whorwell P . Ambulatory abdominal inductance plethysmography: towards objective assessment of abdominal distension in irritable bowel syndrome. Gut. 2001; 48(2):216-20. PMC: 1728192. DOI: 10.1136/gut.48.2.216. View

19.

Jiang X, Locke 3rd G, Choung R, Zinsmeister A, Schleck C, Talley N . Prevalence and risk factors for abdominal bloating and visible distention: a population-based study. Gut. 2008; 57(6):756-63. PMC: 2581929. DOI: 10.1136/gut.2007.142810. View

20.

Sandler R, Stewart W, Liberman J, Ricci J, Zorich N . Abdominal pain, bloating, and diarrhea in the United States: prevalence and impact. Dig Dis Sci. 2000; 45(6):1166-71. DOI: 10.1023/a:1005554103531. View