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Gas-Bloat Syndrome

  • Carolina Malagelada
  • Juan R. Malagelada
Chapter

Abstract

Gas-bloat syndrome refers to a three-faceted clinical picture: the patient feels bloated; the abdomen distends; and the individual may verbalize the discomfort as suffering from “too much gas.” Nowadays, it is more often designated and classified as functional bloating by the Rome criteria (with or without abdominal distension). The gas-bloat syndrome is produced by several interacting mechanisms including excess accumulation of intra-luminal air and/or fluid in the gut, visceral hypersensitivity, and abnormal viscera-somatic reflexes that reshape the abdominal cavity creating the appearance of distension. The diagnosis is largely clinical, but specialized imaging, breath tests, and more sophisticated motility tests may be helpful in selected cases. Treatment is tailored to symptom severity and patient concerns, ranging from simple reassurance to dietary modification and pharmacotherapy to help clear retained stool in patients with constipation, reduce gas production, decrease visceral hypersensitivity, and correct abnormal chest-diaphragm-abdominal muscle activity by biofeedback.

Keywords

Bloating Gas-bloat syndrome Abdominal distension Irritable bowel syndrome Functional dyspepsia Gas production Gas evacuation Viscero-somatic dyssynergia 

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Essential Reading

  1. Burri E, Barba E, Huaman JW, Cisternas D, Accarino A, Soldevilla A, et al. Mechanisms of postprandial abdominal bloating and distension in functional dyspepsia. Gut. 2014;63(3):395–400. A human mechanistic study showing the similarities between dyspepsia and IBS-associated bloating.CrossRefGoogle Scholar
  2. Drossman DA. Functional gastrointestinal disorders: history, pathophysiology, clinical features and Rome IV. Gastroenterology. 2016; A summarized compendium of the latest Rome consensus project (IV) providing the latest classification, features, and diagnostic criteria for the main functional gut disorders.Google Scholar
  3. Malagelada JR, Accarino A, Azpiroz F. Bloating and abdominal distension: old misconceptions and current knowledge. Am J Gastroenterol. 2017;112(8):1221–31. An updated review on the topic describing the various clinical presentations, appropriate diagnostic procedures, and management.CrossRefGoogle Scholar
  4. Pimentel M, Lembo A, Chey WD, Zakko S, Ringel Y, Yu J, et al. Rifaximin therapy for patients with irritable bowel syndrome without constipation. N Engl J Med. 2011;364(1):22–32. A controlled trial showing the efficacy of antibiotic rifaximin therapy relieving IBS-associated bloating.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Carolina Malagelada
    • 1
    • 2
  • Juan R. Malagelada
    • 1
    • 2
  1. 1.Digestive System Research Unit, University Hospital Vall d’HebronBarcelonaSpain
  2. 2.Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd)BarcelonaSpain

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