Role of Colonic Fermentation in the Perception of Colonic Distention in Irritable Bowel Syndrome and Functional Bloating

Michele Di Stefano, Emanuela Miceli, Antonio Missanelli, Samanta Mazzocchi, Paola Tana, Gino Roberto Corazza

Research output: Contribution to journalArticlepeer-review

Abstract

Background & Aims: Bloating represents a frequent gastrointestinal symptom, but the pathophysiologic mechanism responsible for its onset is still largely unknown. Patients very frequently attribute the sensation of bloating to the presence of excessive bowel gas, but not all patients with gas-related symptoms exhibit increased intestinal production of gas. It is therefore possible that other still unrecognized mechanisms might contribute to its pathophysiology. Our aim was to evaluate whether a subgroup of patients affected by functional abdominal bloating presents hypersensitivity to colonic fermentation. Methods Sixty patients affected by functional gastrointestinal disorders (11 functional bloating, 36 constipation-predominant, and 13 diarrhea-predominant irritable bowel syndrome) and moderate to severe bloating took part in the study. Twenty sex- and age-matched healthy volunteers were enrolled as a control group. All the subjects underwent a preliminary evaluation of breath hydrogen excretion after oral lactulose. Then, on a separate day, an evaluation of sensitivity thresholds at rectal level was performed with a barostat before and after the induction of colonic fermentation with oral lactulose. A control test with electrolyte solution was also performed. Results Both breath hydrogen excretion and mouth-to-cecum transit time did not differ between the 4 groups studied. Neither electrolyte solution nor lactulose modified sensitivity thresholds in healthy volunteers. In low hydrogen producers, basal perception and discomfort thresholds were similar to high hydrogen producers, but after lactulose both perception and discomfort thresholds were significantly reduced only in low hydrogen producers. Conclusions A subgroup of patients with functional gastrointestinal disorders and moderate to severe bloating might have hypersensitivity to products of colonic fermentation.

Original languageEnglish
Pages (from-to)1242-1247
Number of pages6
JournalClinical Gastroenterology and Hepatology
Volume4
Issue number10
DOIs
Publication statusPublished - Oct 2006

ASJC Scopus subject areas

  • Gastroenterology

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