Impaired transit and tolerance of intestinal gas in the irritable bowel syndrome

Citation
J. Serra et al., Impaired transit and tolerance of intestinal gas in the irritable bowel syndrome, GUT, 48(1), 2001, pp. 14-19
Citations number
25
Categorie Soggetti
Gastroenerology and Hepatology","da verificare
Journal title
GUT
ISSN journal
00175749 → ACNP
Volume
48
Issue
1
Year of publication
2001
Pages
14 - 19
Database
ISI
SICI code
0017-5749(200101)48:1<14:ITATOI>2.0.ZU;2-3
Abstract
Background-Patients with irritable bowel syndrome (IBS) frequently complain of excessive gas but their fasting volume of intestinal gas is apparently normal. We hypothesised that the pathophysiological mechanism involved may be impairment of intestinal gas transit. Aim-To investigate intestinal gas transit and tolerance in IBS patients com pared with healthy subjects. Methods-A gas mixture (N-2, O-2, and CO2 in venous proportions) was infused into the jejunum of 20 patients with IBS and 20 healthy controls at 12 ml/ min for four hours. Gas evacuation, initially flatus from the anus (two hou rs) and then intrarectally (two hours), was continuously recorded. Symptom perception (0-6 scale) and abdominal distension were measured at 10 minute intervals. Results-After two hours of external gas (flatus) collection, 18 of 20 IBS p atients had developed gas retention (>400 ml), increased gastrointestinal s ymptoms (score >3), or abdominal distension (>3 mm girth increment) compare d with only four of 20 control subjects. During intrarectal gas collection, 13 of 17 patients still exhibited abnormal responses. Conclusion-A large proportion of patients with IBS can be shown to have imp aired transit and tolerance of intestinal gas loads. This anomaly may repre sent a possible mechanism of IBS symptoms, specifically pain and bloating.