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

M, Di Stefano; Miceli, Emanuela; Missanelli, Antonio; Mazzocchi, S.; Tana, P.

doi:10.1016/j.cgh.2006.07.004

Cited by 19 publications

(15 citation statements)

References 29 publications

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“…We therefore performed a post hoc analysis to reconsider our results according to the presence of visceral hypersensitivity to colonic fermentation. According to the presence of a significant reduction ([2 mmHg) of rectosigmoid discomfort thresholds during fermentation at the cecum level of orally administered lactulose [13], 11 patients were hypersensitive and 13 patients were normosensitive to colonic fermentation. Mean basal discomfort threshold was 9.9 ± 1.5 mmHg over MDP in normosensitive patients and 10.9 ± 2.1 mmHg over MDP in hypersensitive patients (p = NS).…”

Section: Resultsmentioning

confidence: 99%

“…In accordance with our previous results, a significant reduction of the discomfort threshold, indicative of the presence of hypersensitivity to colonic fermentation, was considered to be defined as a difference between fasting and post-solution value [2 mmHg, corresponding to at least two steps in the distension protocol [13].…”

Section: Barostat Testmentioning

confidence: 98%

“…After the administration of the lactulose solution, we monitored breath H 2 excretion and when a sustained increase of breath H 2 excretion was detected, indicating the arrival of the test solution in the colon and the beginning of its fermentation by the colonic flora, a second series of mechanical distentions was performed to test whether lactulose modified rectal sensitivity thresholds [13].…”

Section: Barostat Testmentioning

confidence: 99%

“…The hypothesis is based on the observation of sudden onset of bloating when malabsorbed carbohydrates reach colonic bacterial flora, as in carbohydrate intolerance [11,12]; it is, therefore, possible that an increased production of gas at the colonic level from fermentable substrates may be responsible for bloating onset in IBS. However, even this ''colonic'' mechanism might be significant only in a subgroup of IBS patients, as we recently showed that hypersensitivity to physiologic colonic fermentation may be important in another subgroup of IBS patients with severe bloating [13].…”

Section: Introductionmentioning

confidence: 95%

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Colonic hypersensitivity is a major determinant of the efficacy of bloating treatment in constipation-predominant irritable bowel syndrome

Tana

Mengoli

et al. 2010

Intern Emerg Med

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The pathophysiology of bloating is largely unknown, and many mechanisms have been proposed. An alteration of intestinal gas production may have a role in a subgroup of patients, but available data are conflicting. We have previously shown that hypersensitivity to colonic fermentation is associated with severe bloating in a subgroup of patients with low intestinal gas production. Accordingly, we evaluated whether modification of intestinal gas production improves bloating severity according to the presence of visceral hypersensitivity to colonic fermentation. Twenty-four IBS-C patients with severe bloating underwent intestinal gas production measurement by hydrogen breath test after lactulose, and a recto-sigmoid barostat test in order to evaluate sensitivity thresholds in a basal condition and after induction of colonic fermentation. The subjects were then randomly assigned to receive either rifaximin or placebo according to a double-blind, randomized, cross-over trial. Rifaximin induced an improvement of symptom severity. A post hoc analysis according to the presence of hypersensitivity to colonic fermentation shows that rifaximin induces a significant improvement in symptom severity only in normosensitive, hyperproducer patients. Modulation of colonic flora, in order to reduce fermentation, does not interfere with bloating severity in patients with visceral hypersensitivity, thus suggesting that in this subgroup of subjects gas production is not crucial for the onset of bloating.

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Section: Resultsmentioning

confidence: 99%

Section: Barostat Testmentioning

confidence: 98%

Section: Barostat Testmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

See 2 more Smart Citations

Colonic hypersensitivity is a major determinant of the efficacy of bloating treatment in constipation-predominant irritable bowel syndrome

Tana

Mengoli

et al. 2010

Intern Emerg Med

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“…W badaniu Di Stefano i wsp. wykazano, że prawdopodobnie głównym czynnikiem patogenetycznym jest nadwrażliwość na produkty fermentacji, która występuje w jelicie grubym [14]. Innym czynnikiem decydującym o pojawianiu się wzdęcia brzucha u osób z zaparciem jest stwierdzana w tej grupie nadwrażliwość trzewna na wzrost ciśnienia w świetle jelita grubego [15].…”

Section: Wzdęcia Brzucha a Zaparcia Stolcaunclassified

Abdominal bloating – an important symptom in everyday medical practice

Eder¹,

Stawczyk‐Eder²,

Łykowska‐Szuber³

et al. 2012

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StreszczenieWzdęcie brzucha należy do najczęstszych objawów ze strony przewodu pokarmowego zgłaszanych przez pacjentów w codziennej praktyce lekarskiej. W istotny sposób obniża ono jakość życia. Może pojawiać się jako izolowany symptom, ale częściej jest elementem obrazu klinicznego innych jednostek chorobowych. Niniejsza praca ma na celu ukazanie danych epidemiologicznych dotyczących wzdęcia jako objawu chorobowego. Przedstawiona zostanie także charakterystyka chorób z kręgu zarówno zaburzeń czynnościowych, jak i organicznych przewodu pokarmowego, w których wzdęcie występuje powszechnie obok głównych objawów. AbstractAbdominal bloating is one of the most common gastrointestinal symptoms, which very often impairs the health-related quality of life. It can be a part of many different gastrointestinal disorders, but it can also be an isolated phenomenon. In the current work we present the epidemiological and clinical characteristics of abdominal bloating and other diseases in which this symptom often appears.

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Syndrome de l’intestin irritable : rôle de la flore et intérêt potentiel des probiotiques

Ducrotté¹

2007

Colon Rectum

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La mise en évidence d'un état pro-inflammatoire au cours du SII a permis d'émettre l'hypothèse qu'il pouvait exister des altérations de la flore digestive au cours du SII. Par rapport aux sujets sains, quelques travaux très récents suggèrent qu'il existe un déséqui-libre qualitatif de la flore colique chez ces patients. Par ailleurs, d'autres travaux, émanant principalement d'une seule équipe, suggèrent qu'il existe des anomalies quantitatives de la flore, ce qui pourrait être une cible thérapeutique. Les probiotiques, en modulant l'équilibre de la flore digestive, sont une piste thérapeutique intéressante. Quelques études ont montré que certains probiotiques étaient susceptibles d'améliorer de façon prolongée les patients atteints de SII.Mots clés : Syndrome de l'intestin irritable -ProbiotiquesFlore bactérienne -Colonisation bactérienne chronique Irritable bowel syndrome: role of intestinal flora and potential role of probiotics Abstract: The demonstration of a pro-inflammatory condition as part of IBS has resulted in the suggestion that there may be intestinal flora alterations with irritable bowel syndrome. With respect to healthy subjects, some very recent research has suggested that a qualitative imbalance of intestinal flora exists in these patients. Moreover, further research from another group found quantitative differences of flora which could be a therapeutic target. Probiotics, by modulating intestinal flora balance, are an interesting therapeutic option. A few studies have demonstrated that some probiotics could have long-lasting improvements for patients suffering from irritable bowel syndrome.

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

Cited by 19 publications

References 29 publications

Colonic hypersensitivity is a major determinant of the efficacy of bloating treatment in constipation-predominant irritable bowel syndrome

Colonic hypersensitivity is a major determinant of the efficacy of bloating treatment in constipation-predominant irritable bowel syndrome

Abdominal bloating – an important symptom in everyday medical practice

Syndrome de l’intestin irritable : rôle de la flore et intérêt potentiel des probiotiques

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