Relationship of Abdominal Bloating to Distention in Irritable Bowel Syndrome and Effect of Bowel Habit
Open accessAbstract
Background & aims The relationship between the sensation of bloating, often ranked as the most bothersome symptom by patients with irritable bowel syndrome (IBS), and actual distention manifest as an increase in abdominal girth is controversial. Investigation of this problem has been hampered by the lack of a reliable ambulatory technique to measure abdominal girth. The aim of this study was to use the technique of abdominal inductance plethysmography to compare diurnal variation in girth in IBS patients and healthy volunteers, relating these changes to the sensation of bloating.Methods Abdominal girth was recorded for 24 hours in 20 IBS-constipation (age, 18-73 y), 20 IBS-diarrhea (age, 25-62 y) and 10 IBS-alternating (age, 21-59 y) female patients meeting Rome II criteria and 20 healthy female controls (age, 18-67 y). All subjects pursued normal daily activities, recording their symptoms of bloating and pain together with bowel habit.Results All patients with IBS, irrespective of bowel habit, reported significantly greater bloating than controls (P < .0001). 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). Neither bloating nor distention in IBS was related to body mass index, age, parity, or psychologic status.Conclusions Abdominal distention is a clearly definable phenomenon in IBS that can reach 12 cm. However, it only occurs in half of patients reporting bloating, and the 2 only correlate in IBS-constipation. Bloating and distention may differ pathophysiologically and this appears to be reflected in the bowel habit subtype.
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The presence of bloating is not required to fulfil the Rome IV criteria but, if present, is highly suggestive of IBS, and is often accompanied by visible abdominal distension.
“The presence of bloating is not required to fulfil the Rome IV criteria but, if present, is highly suggestive of IBS, and is often accompanied by visible abdominal distension.114”
From British Society of Gastroenterology guidelines on the management of irritable bowel syndrome (2021) · cites this paper as [114]
The Results (p. 1) report greater bloating in IBS patients than controls and distention in 48% of patients; the Discussion (p. 7) notes that some IBS patients do not experience bloating. However, the study used Rome II criteria, not Rome IV, and does not establish that bloating is highly suggestive of IBS; seven of 20 healthy volunteers also reported bloating (p. 3). (LLM, conf=0.88)
Experimental — accuracy not yet measuredAbdominal bloating is not a cardinal symptom but is very common, and supports the diagnosis, particularly if it is diurnal.
“Abdominal bloating is not a cardinal symptom but is very common, and supports the diagnosis, particularly if it is diurnal. It is often accompanied by visible abdominal distension. 65”
From Irritable bowel syndrome (2020) · cites this paper as [65]
The introduction (p. 1) says bloating is reported by up to 96% of IBS patients and typically worsens during the day. The results (p. 1) also report that 48% of patients had measurable distention. The paper does not establish that bloating is non-cardinal or that a diurnal pattern supports an IBS diagnosis; it notes bloating also occurs in the general population. (LLM, conf=0.87)
Experimental — accuracy not yet measuredAbdominal bloating is often accompanied by visible abdominal distension.
“Abdominal bloating is not a cardinal symptom but is very common, and supports the diagnosis, particularly if it is diurnal. It is often accompanied by visible abdominal distension. 65”
From Irritable bowel syndrome (2020) · cites this paper as [65]
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- Authors
- Houghton, L. A., Lea, R., Agrawal, A., Reilly, B., & Whorwell, P. J.
- Affiliations
- Wythenshawe Hospital (GB)
- Corresponding author
- Houghton, Lesley A.
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2006-10
- Volume
- 131
- Issue
- 4
- Pages
- 1003-1010
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W2038327913
- Cited by
- 138
- References
- 46
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 2 · 2023: 4 · 2022: 7 · 2021: 12 · 2020: 5 · 2019: 5 · 2018: 6 · 2017: 3 · 2016: 7 · 2015: 2 · 2014: 10 · 2013: 8 · 2012: 6
- FWCI
- 11.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Health Professions › Pharmacy › Infant Health and Development
- Keywords
- irritable bowel syndrome, bloating, abdominal distension, abdominal girth, inductance plethysmography, bowel habits, diurnal variation, Rome II criteria
- MeSH terms
- Abdomen, Adolescent, Adult, Age Factors, Aged, Anxiety, Circadian Rhythm, Constipation, Defecation, Dilatation, Pathologic, Female, Flatulence, Habits, Humans, Middle Aged, Parity, Pregnancy, Abdominal Pain, Body Mass Index, Irritable Bowel Syndrome
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