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Neurogastroenterology and Motility Dec 2019Some patients complain that eating lettuce, gives them gas and abdominal distention. Our aim was to determine to what extent the patients' assertion is sustained by... (Comparative Study)
Comparative Study
BACKGROUND
Some patients complain that eating lettuce, gives them gas and abdominal distention. Our aim was to determine to what extent the patients' assertion is sustained by evidence.
METHODS
An in vitro study measured the amount of gas produced during the process of fermentation by a preparation of human colonic microbiota (n = 3) of predigested lettuce, as compared to beans, a high gas-releasing substrate, to meat, a low gas-releasing substrate, and to a nutrient-free negative control. A clinical study in patients complaining of abdominal distention after eating lettuce (n = 12) measured the amount of intestinal gas and the morphometric configuration of the abdominal cavity in abdominal CT scans during an episode of lettuce-induced distension as compared to basal conditions.
KEY RESULTS
Gas production by microbiota fermentation of lettuce in vitro was similar to that of meat (P = .44), lower than that of beans (by 78 ± 15%; P < .001) and higher than with the nutrient-free control (by 25 ± 19%; P = .05). Patients complaining of abdominal distension after eating lettuce exhibited an increase in girth (35 ± 3 mm larger than basal; P < .001) without significant increase in colonic gas content (39 ± 4 mL increase; P = .071); abdominal distension was related to a descent of the diaphragm (by 7 ± 3 mm; P = .027) with redistribution of normal abdominal contents.
CONCLUSION AND INFERENCES
Lettuce is a low gas-releasing substrate for microbiota fermentation and lettuce-induced abdominal distension is produced by an uncoordinated activity of the abdominal walls. Correction of the somatic response might be more effective than the current dietary restriction strategy.
Topics: Abdominal Cavity; Abdominal Wall; Adult; Animals; Anthropometry; Biofeedback, Psychology; Cattle; Diagnosis, Differential; Diaphragm; Digestion; Dilatation, Pathologic; Electromyography; Feces; Female; Fermentation; Flatulence; Gases; Gastrointestinal Microbiome; Humans; In Vitro Techniques; Lactuca; Meat; Middle Aged; Muscle Contraction; Phaseolus; Saline Solution; Tomography, X-Ray Computed; Young Adult
PubMed: 31402544
DOI: 10.1111/nmo.13703 -
European Journal of Vascular and... Apr 1997
Topics: Animals; Aorta; Aortic Aneurysm, Abdominal; Dilatation, Pathologic; Disease Models, Animal; Humans; Stents; Swine
PubMed: 9133999
DOI: 10.1016/s1078-5884(97)80090-1 -
European Journal of Vascular and... Aug 2021
Topics: Anastomosis, Surgical; Aorta, Abdominal; Blood Vessel Prosthesis; Computed Tomography Angiography; Dilatation, Pathologic; Endovascular Procedures; Hepatic Artery; Humans; Middle Aged; Stents
PubMed: 34144882
DOI: 10.1016/j.ejvs.2021.05.004 -
MMW Fortschritte Der Medizin Nov 2017
Review
Topics: Abdomen; Abdominal Pain; Algorithms; Celiac Disease; Diagnosis, Differential; Dilatation, Pathologic; Food Hypersensitivity; Humans; Wheat Hypersensitivity
PubMed: 29159608
DOI: 10.1007/s15006-017-9601-x -
Ultrasound in Obstetrics & Gynecology :... Sep 2019To investigate intra-abdominal bowel dilation (IABD) in the prediction of complex gastroschisis.
OBJECTIVE
To investigate intra-abdominal bowel dilation (IABD) in the prediction of complex gastroschisis.
METHODS
This was a retrospective study of 174 singleton pregnancies with isolated fetal gastroschisis, resulting in live birth and with available ultrasound images from visits at both 20-22 and 30-32 weeks' gestation. IABD was measured as the greatest transverse diameter of the most dilated intra-abdominal bowel segment, by an operator blinded to postnatal outcome. The distribution of IABD measurements in those with complex and those with simple gastroschisis was determined and the best cut-off value to predict complex gastroschisis was selected using receiver-operating characteristics (ROC) curves. The area under the ROC curve (AUC), detection rate (DR), false-positive rate (FPR), positive predictive value (PPV) and negative predictive value (NPV) were determined.
RESULTS
The study population included 39 (22.4%) cases of complex and 135 (77.6%) cases of simple gastroschisis. In the prediction of complex gastroschisis, the AUC at 20-22 weeks' gestation was 0.742 (95% CI, 0.628-0.856) and the respective value for 30-32 weeks was 0.820 (95% CI, 0.729-0.910). At the IABD cut-off of 7 mm at 20-22 weeks, DR, FPR, PPV and NPV for complex gastroschisis were 61.5%, 6.7%, 72.7% and 89.4%, respectively, and at IABD cut-off of 14 mm at 30-32 weeks, the respective values were 64.9%, 5.9%, 75.0% and 90.7%.
CONCLUSION
Measurement of IABD at 20-22 or at 30-32 weeks' gestation is useful in the prediction of complex gastroschisis. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
Topics: Dilatation, Pathologic; Female; Gastroschisis; Gestational Age; Humans; Intestines; Predictive Value of Tests; Pregnancy; Pregnancy Outcome; ROC Curve; Retrospective Studies; Ultrasonography, Prenatal
PubMed: 31264279
DOI: 10.1002/uog.20367 -
Neurogastroenterology and Motility Jun 2013We previously showed that abdominal distension in patients with functional gut disorders is due to a paradoxical diaphragmatic contraction without major increment in...
BACKGROUND
We previously showed that abdominal distension in patients with functional gut disorders is due to a paradoxical diaphragmatic contraction without major increment in intraabdominal volume. Our aim was to characterize the pattern of gas retention and the abdomino-thoracic mechanics associated with abdominal distension in patients with intestinal dysmotility.
METHODS
In 15 patients with manometrically proven intestinal dysmotility, two abdominal CT scans were performed: one during basal conditions and other during an episode of severe abdominal distension. In 15 gender- and age-matched healthy controls, a basal scan was performed.
KEY RESULTS
In basal conditions, patients exhibited more abdominal gas than healthy subjects, particularly in the small bowel, and the volume significantly increased during an episode of distension. During episodes of abdominal distension, the increase in abdominal content was associated with increased girth and antero-posterior abdominal diameter, as well as a cephalic displacement of the diaphragm, which reduced the height of the lung. The consequent reduction in the air volume of the lung was attenuated by an increase in the antero-posterior diameter of the chest.
CONCLUSIONS & INFERENCES
Abdominal distension in patients with severe intestinal dysfunction is related to marked pooling of gut contents, particularly in the small bowel. This increase in content is accommodated within the abdominal cavity by a global and coordinated abdomino-phreno-thoracic response, involving an accommodative ascent of the diaphragm and a compensatory expansion of the chest wall.
Topics: Abdomen; Adolescent; Adult; Dilatation, Pathologic; Female; Gastrointestinal Diseases; Gastrointestinal Motility; Humans; Image Processing, Computer-Assisted; Male; Middle Aged; Radiography, Abdominal; Thorax
PubMed: 23607758
DOI: 10.1111/nmo.12128 -
Neurogastroenterology and Motility Aug 2005Abdominal bloating is an extremely common symptom affecting up to 96% of patients with functional gastrointestinal disorders and even 30% of the general population. To... (Review)
Review
Abdominal bloating is an extremely common symptom affecting up to 96% of patients with functional gastrointestinal disorders and even 30% of the general population. To date bloating has often been viewed as being synonymous with an actual increase in abdominal girth, but recent evidence suggests that this is not necessarily the case. This review examines the relationship between the symptom of bloating and the physical sign of abdominal distension, as well as examining the epidemiology, pathophysiology and treatment options available for this debilitating aspect of the functional gastrointestinal disorders. Pathophysiological mechanisms explored include psychological factors, intestinal gas accumulation, fluid retention, food intolerance and malabsorption of sugars, weakness of abdominal musculature, and altered sensorimotor function. Treatment options are currently rather limited but include dietary changes, pharmacological approaches, probiotics and hypnotherapy.
Topics: Abdomen; Dilatation, Pathologic; Gases; Gastrointestinal Diseases; Humans; Intestines
PubMed: 16078938
DOI: 10.1111/j.1365-2982.2005.00666.x -
Gastrointestinal Endoscopy Clinics of... Apr 2019Isolated biliary dilation, as an incidental diagnosis, is increasing owing to an increase in the use of noninvasive abdominal imaging and poses a diagnostic challenge to... (Review)
Review
Isolated biliary dilation, as an incidental diagnosis, is increasing owing to an increase in the use of noninvasive abdominal imaging and poses a diagnostic challenge to physicians especially when further noninvasive diagnostic testing fails to reveal an etiology. This article reviews available data describing the natural history of this clinical scenario and the impact of endoscopic ultrasound examination in the evaluation of unexplained dilation of the common bile duct.
Topics: Bile Ducts; Dilatation, Pathologic; Endosonography; Humans; Liver Function Tests; Magnetic Resonance Imaging; Tomography, X-Ray Computed
PubMed: 30846146
DOI: 10.1016/j.giec.2018.11.001 -
Annals of Western Medicine and Surgery Jul 1952
Topics: Abdomen; Abdominal Cavity; Dilatation, Pathologic; Humans; Pain
PubMed: 12977066
DOI: No ID Found -
Cirugia Espanola Nov 2010Congenital dilations of the biliary tract are a group of rare conditions, commonly associated with the presence of an abnormality at the junction of the common bile duct... (Review)
Review
Congenital dilations of the biliary tract are a group of rare conditions, commonly associated with the presence of an abnormality at the junction of the common bile duct and pancreatic duct, which may lead to the reflux of pancreatic juice within the biliary tree. The main clinical symptoms are, abdominal pain, cholangitis and acute pancreatitis, and the most serious complication is malignant degeneration. The treatment of choice is cholecystectomy and complete excision of the bile duct from its bifurcation to its intra-pancreatic segment.
Topics: Biliary Tract; Congenital Abnormalities; Dilatation, Pathologic; Humans
PubMed: 20554272
DOI: 10.1016/j.ciresp.2010.04.003