Clinical Dimensions of Bloating in Functional Gastrointestinal Disorders

Ryu, Min Sun; Jung, Hye Kyung; Ryu, Jae-In; Kim, Jung Sook; Kong, Kyung Ae

doi:10.5056/jnm15167

Cited by 18 publications

(24 citation statements)

References 28 publications

(37 reference statements)

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“…Studies have shown that younger patients are more likely to experience bloating. 5 Our study builds upon this knowledge, and we found as age increased, severity of bloating decreased. Visceral hypersensitivity is one possible pathophysiologic mechanisms of bloating 12,13 and younger age has been positively associated with visceral hypersensitivity.…”

Section: Discussionsupporting

confidence: 60%

Symptom severity and clinical characteristics of patients with bloating

Gardiner

Singh

Ballou

et al. 2021

Neurogastroenterology Motil

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Background: Abdominal bloating is common in functional gastrointestinal disorders (FGID). To better characterize this patient population, we evaluated clinical and psychological characteristics of bloating and analyzed their differences by bloating severity.Methods: Patients with FGIDs evaluated at a single academic outpatient referral gastroenterology clinic were surveyed. Bloating severity was classified as minimal, moderate or severe. Symptom-specific questionnaires were used to evaluate bowel habits, abdominal bloating, depression, anxiety, somatization and sleep disturbance. Associations between bloating severity, clinical characteristics and FGID subtypeswere analyzed in univariate and multivariate modeling.Key Results: Of 612 FGID patients included (78% female, mean age of 44 ± 16.5 years), bloating was reported as minimal in 231(37.8%), moderate in 217(35.4%), or severe in 164(26.8%). Patients with severe bloating were more likely to be female, younger, and have co-existing functional dyspepsia than those with minimal bloating (p < 0.05).Bloating severity and severity of abdominal distension were significantly correlated (p < 0.05). On multivariable regression, patients who met criteria for functional constipation and functional dyspepsia had 80% and 125% higher odds, respectively, of severe bloating compared to minimal to moderate bloating. Younger age, abdominal pain and constipation severity, and somatization scores were also independently associated with severity of bloating. Conclusions & Inferences:Severe bloating is associated with younger age, and with more severe abdominal pain, constipation, and somatization. Patients who met criteria for functional constipation and functional dyspepsia are more likely to experience severe bloating.

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Section: Discussionsupporting

confidence: 60%

Symptom severity and clinical characteristics of patients with bloating

Gardiner

Singh

Ballou

et al. 2021

Neurogastroenterology Motil

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“…We used symptoms to identify naturally occurring clusters in the data. We considered all intestinal symptoms that can be associated with IBS, such as upper and lower abdominal pain or discomfort, change in stool form or frequency, abdominal bloating, dyspepsia, gastro‐oesophageal reflux, and post‐prandial symptoms and nausea . We also considered individual items from the PHQ‐15 questionnaire.…”

Section: Methodsmentioning

confidence: 99%

Derivation and validation of a diagnostic test for irritable bowel syndrome using latent class analysis

Sood

Gracie

Gold

et al. 2017

Aliment Pharmacol Ther

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Summary Background The accuracy of symptom‐based diagnostic criteria for irritable bowel syndrome (IBS) is modest. Aims To derive and validate a new test that utilises latent class analysis. Methods Symptom, colonoscopy, and histology data were collected from 1981 patients and 360 patients in two cohorts referred to secondary care for investigation of their gastrointestinal symptoms in Canada and the UK, respectively. Latent class analysis was used to identify naturally occurring clusters in patient‐reported symptoms in the Canadian dataset, and the latent class model derived from this was then applied to the UK dataset in order to validate it. Sensitivity, specificity, and positive and negative likelihood ratios (LRs) were calculated for the latent class models. Results In the Canadian cohort, the model had a sensitivity of 44.7% (95% CI 40.0–50.0) and a specificity of 85.3% (95% CI 83.4–87.0). Positive and negative LRs were 3.03 (95% CI 2.57–3.56) and 0.65 (95% CI 0.59–0.71) respectively. A maximum positive LR of 3.93 was achieved following construction of a receiver operating characteristic curve. The performance in the UK cohort was similar, with a sensitivity and specificity of 52.5% (95% CI 42.2–62.7) and 84.3% (95% CI 79.3–88.6), respectively. Positive and negative LRs were 3.35 (95% CI 2.38–4.70) and 0.56 (95% CI 0.45–0.68), respectively, with a maximum positive LR of 4.15. Conclusions A diagnostic test for IBS, utilising patient‐reported symptoms incorporated into a latent class model, performs as accurately as symptom‐based criteria. It has potential for improvement via addition of clinical markers, such as coeliac serology and faecal calprotectin.

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“…Bloating is one of the most frequent symptoms reported by patients with gastrointestinal functional disorders [ 1 , 2 , 3 , 4 ]. In particular, over 90% of subjects with irritable bowel syndrome (IBS) complain of bloating [ 5 , 6 , 7 , 8 , 9 , 10 , 11 ] and, in addition, 20–30% of the general population suffers this functional gastrointestinal discomfort [ 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Beneficial Effects on Abdominal Bloating with an Innovative Food-Grade Formulation of Curcuma longa and Boswellia serrata Extracts in Subjects with Irritable Bowel Syndrome and Small Bowel Dysbiosis

et al. 2022

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Bloating is a symptom frequently reported by subjects with irritable bowel syndrome (IBS) and small bowel dysbiosis, and Low FODMAP’s diet (LFD) has been used to treat them. Extracts of Curcuma longa and Boswellia serrata share anti-inflammatory and antimicrobial effects that could be useful in the management of these clinical conditions. The aim of this study was to evaluate the efficacy of curcumin and boswellia extracts (as Curcumin Boswellia Phytosome, CBP) and LFD on the relief of abdominal bloating in IBS subjects with small bowel dysbiosis, in comparison to LFD alone, in a 30-day supplementation, randomized trial. IBS participants were randomized to either the intervention (500 mg bid of CBP and LFD) or control arm (LFD). Small bowel dysbiosis has been defined by an increase of urinary indican with normal urinary skatole. A total of 67 subjects were recruited. The intervention group (33 subjects) showed a significant decrease (p < 0.0001) of bloating, abdominal pain, and indican values at the end of the study, when compared to the control group (34 subjects). Moreover, the subjects of the intervention group showed a significantly better (p < 0.0001) global assessment of efficacy (GAE) as compared to controls. In conclusion, in subjects with IBS and small bowel dysbiosis, abdominal bloating can be successfully reduced with a supplementation with CBP and LFD.

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Clinical Dimensions of Bloating in Functional Gastrointestinal Disorders

Cited by 18 publications

References 28 publications

Symptom severity and clinical characteristics of patients with bloating

Symptom severity and clinical characteristics of patients with bloating

Derivation and validation of a diagnostic test for irritable bowel syndrome using latent class analysis

Beneficial Effects on Abdominal Bloating with an Innovative Food-Grade Formulation of Curcuma longa and Boswellia serrata Extracts in Subjects with Irritable Bowel Syndrome and Small Bowel Dysbiosis

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