Abdominal Accommodation: A Coordinated Adaptation of the Abdominal Wall to Its Content

Villòria, Albert; Azpiroz, Fernando; Soldevilla, Alfredo; Pérez, F. Fernández; Malagelada, J.-R.

doi:10.1111/j.1572-0241.2008.02141.x

Cited by 48 publications

(61 citation statements)

References 19 publications

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“…This pattern strongly suggests functional bloating is not associated with neuromuscular gut disturbance [38,39].…”

Section: Emg Of Diaphragmatic and Abdominal Musclesmentioning

confidence: 93%

The Dysfunctional Gut

Malagelada¹,

Malagelada²

2010

Curr Gastroenterol Rep

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After many decades debating whether the clinical manifestations of patients with functional digestive symptoms originate "in their minds" or "in their guts," arguments remain strong on both sides of the controversy. However, advances in understanding of gut physiology and pathophysiology, and persuasive evidence on the bidirectionality of the regulatory traffic between the enteric and central nervous systems, are helping to characterize clinical situations in which we can legitimately speak of gut dysfunction, as opposed to others where symptoms are not associated with apparent or detectable gut disturbances and may truly represent somatization of an affective disorder. In this review, we describe available clinically applicable technology, albeit in specialized clinical research units, that may be used to discern whether or not challenging patients have gut sensory or motor disturbances. The practical yield of applying such methods to diagnostic investigation may be substantial, because it establishes a plausible mechanism of disease that may be used in patient management and patient persuasion, to remove uncertainties and to prevent futile repetition of conventional diagnostic tests. By evolving from symptom analysis to mechanism-based diagnosis, our gastroenterology community may progress toward the goal of delivering the full diagnostic spectrum from altered morphology to disturbed function.

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“…This pattern strongly suggests functional bloating is not associated with neuromuscular gut disturbance [38,39].…”

Section: Emg Of Diaphragmatic and Abdominal Musclesmentioning

confidence: 93%

The Dysfunctional Gut

Malagelada¹,

Malagelada²

2010

Curr Gastroenterol Rep

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“…Research on bloating and distension has been hampered by the lack of availability of suitable methods of investigation but this has been changed by the advent of techniques such as the gas challenge technique [4,5], abdominal inductance plethysmography [6,7], abdominal and diaphragmatic electromyography [8,9], CT scanning [10], and no doubt magnetic resonance imaging will contribute in the future. The application of such methodology has resulted in the recognition that bloating tends to be associated with a phenotype characterised by increased visceral sensitivity [11], impaired gas handling [4], and diarrhoea [12], whereas distension is more often related to constipation [12], delayed gastrointestinal transit [12], weak abdominal musculature [13], and an abnormal accommodation reflex [8][9][10] where there is paradoxical contraction of diaphragmatic and abdominal muscles in response to an increase in abdominal pressure.…”

Section: Putative Causes Of Bloating and Distensionmentioning

confidence: 99%

“…The application of such methodology has resulted in the recognition that bloating tends to be associated with a phenotype characterised by increased visceral sensitivity [11], impaired gas handling [4], and diarrhoea [12], whereas distension is more often related to constipation [12], delayed gastrointestinal transit [12], weak abdominal musculature [13], and an abnormal accommodation reflex [8][9][10] where there is paradoxical contraction of diaphragmatic and abdominal muscles in response to an increase in abdominal pressure. In addition, there is evidence that in at least a proportion of patients with IBS, the bacterial flora of the gut may be disturbed [14][15][16] and additionally, fermentation may also contribute to symptoms [17] raising the possibility that these two factors may also contribute to both bloating and distension.…”

Section: Putative Causes Of Bloating and Distensionmentioning

confidence: 99%

Abdominal Bloating and Distension: What Is the Role of the Microbiota

2011

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Most patients with irritable bowel syndrome complain of a sensation of an increase in pressure within their abdomen during the course of the day which is called bloating and, in approximately half of these individuals, this symptom is accompanied by an actual increase in abdominal girth, which is referred to as distension. The pathophysiology of these two phenomena is somewhat different and it is now recognised that a whole variety of overlapping mechanisms are involved. Some of these are potentially amenable to treatment by modification of the bacterial flora of the gut and this article reviews the evidence for this.

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“…During the stretching phase, the shape of the abdomen will change from elliptical to spherical. This change in shape is mainly due to an increase in the antero-posterior diameter and a decrease in the transverse diameter (transverse plane) of the internal abdominal perimeter [8][9][10][11][12].…”

Section: Abdominal Pv Relationshipmentioning

confidence: 99%