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The American Journal of Gastroenterology Sep 2013Bloating and distention are often attributed to dietary factors by patients with irritable bowel syndrome (IBS). This study examined the effects of gas production and...
OBJECTIVES
Bloating and distention are often attributed to dietary factors by patients with irritable bowel syndrome (IBS). This study examined the effects of gas production and visceral hypersensitivity on digestive symptoms after lactose ingestion in a population with lactase deficiency.
METHODS
IBS patients (n=277) and healthy controls (HCs, n=64) underwent a 20-g lactose hydrogen breath test (LHBT) with evaluation of hydrogen gas production and lactose intolerance (LI) symptoms. Abdominal distention (199 IBS, 40 HCs) was measured during LHBT. Rectal sensitivity (74 IBS, 64 HCs) was assessed by barostat studies.
RESULTS
Hydrogen production and distention were similar in IBS patients and HCs during LHBT; however, LI was more frequent in IBS (53.8 vs. 28.1%, P<0.001), especially bloating (39.0% vs. 14.1%, P<0.001) and borborygmi (39.0 vs. 21.9%, P=0.010). Only 59.0% of patients with bloating had distention. No correlation was observed between girth increment and bloating (P=0.585). IBS patients had lower rectal sensory thresholds (P=0.001). Multivariate analysis indicated that hydrogen production increased bloating (odds ratio (OR) 2.19, 95% confidence interval (CI) 1.09-4.39, P=0.028) and borborygmi (OR 12.37, 95% CI 3.34-45.83, P<0.001) but not distention (P=0.673). Visceral hypersensitivity was associated with bloating (OR 6.61, 95% CI 1.75-25.00, P=0.005) and total symptom score (OR 3.78, 95% CI 1.30-10.99, P=0.014).
CONCLUSIONS
Gas production and visceral hypersensitivity both contribute to digestive symptoms, especially bloating and borborygmi, in IBS patients after lactose ingestion. Objective abdominal distention is not correlated with subjective bloating.
Topics: Adult; Carbohydrate Metabolism, Inborn Errors; Dilatation, Pathologic; Female; Flatulence; Humans; Irritable Bowel Syndrome; Lactase; Lactose; Lactose Intolerance; Male; Middle Aged; Physical Stimulation; Sensory Thresholds; Visceral Pain
PubMed: 23917444
DOI: 10.1038/ajg.2013.198 -
Pediatric Nephrology (Berlin, Germany) Oct 1995The megacystis-microcolon-intestinal hypoperistalsis syndrome is a congenital disorder characterized by urinary bladder distension and hypoperistalsis throughout the...
The megacystis-microcolon-intestinal hypoperistalsis syndrome is a congenital disorder characterized by urinary bladder distension and hypoperistalsis throughout the entire gastrointestinal tract. We present a new case with the typical clinical, radiological, and pathological findings of the syndrome. The diagnosis should be suspected in a patient who present clinically with intestinal obstruction and urinary retention, and confirmed with imaging studies, including abdominal plain films, urinary tract ultrasonography, and contrast studies of the colon and the bladder. The prognosis is generally very poor. Our patient died secondary to sepsis on day 5 of life.
Topics: Abnormalities, Multiple; Colon; Diagnosis, Differential; Dilatation, Pathologic; Fatal Outcome; Gastrointestinal Diseases; Humans; Infant, Newborn; Intestinal Obstruction; Male; Peristalsis; Syndrome; Urinary Retention
PubMed: 8580028
DOI: 10.1007/BF00860960 -
BMJ (Clinical Research Ed.) Jun 2012
Topics: Abdominal Pain; Aged; Ascites; Cardiomegaly; Dilatation, Pathologic; Edema; Heart Failure; Hepatic Veins; Humans; Liver Diseases; Liver Function Tests; Male; Tomography, X-Ray Computed; Tricuspid Valve Insufficiency; Vena Cava, Inferior
PubMed: 22693048
DOI: 10.1136/bmj.e2096 -
The New England Journal of Medicine Jan 2013
Topics: Abdominal Pain; Aged; Diagnosis, Differential; Dilatation, Pathologic; Female; Humans; Kidney Failure, Chronic; Lung; Osteomyelitis; Peritoneal Dialysis; Peritoneum; Peritonitis, Tuberculous; Radiography; Sternum; Tuberculosis, Pulmonary
PubMed: 23343067
DOI: 10.1056/NEJMcpc1208142 -
The Journal of the Kansas Medical... May 1951
Topics: Abdomen; Abdominal Cavity; Bromides; Dilatation, Pathologic; Humans; Intestines; Pyridines
PubMed: 14850795
DOI: No ID Found -
Gut Apr 2006
Topics: Abdomen; Abdominal Pain; Aged, 80 and over; Dilatation, Pathologic; Fatal Outcome; Female; Humans; Intestine, Small; Ischemia; Necrosis; Tomography, X-Ray Computed
PubMed: 16531527
DOI: 10.1136/gut.2005.077081 -
Archives of Gynecology and Obstetrics Feb 2005Dilatation of the fetal intra-abdominal umbilical vein is a rare entity. It is unclear whether prenatally diagnosed umbilical vein dilatation is associated with an... (Review)
Review
INTRODUCTION
Dilatation of the fetal intra-abdominal umbilical vein is a rare entity. It is unclear whether prenatally diagnosed umbilical vein dilatation is associated with an increased risk of fetal anomalies or poor perinatal outcome. Umbilical artery waveform notching may be a predictor of cord abnormalities. It seems reasonable following the baby closely after the diagnosis of both conditions.
CASE REPORT AND DISCUSSION
We present here a new case diagnosed by ultrasonography at 30 weeks of gestation with normal fetal outcome and discuss the clinical features and the management of these rare abnormalities.
Topics: Adult; Congenital Abnormalities; Dilatation, Pathologic; Female; Humans; Infant, Newborn; Pregnancy; Pregnancy Outcome; Ultrasonography, Prenatal; Umbilical Arteries; Umbilical Veins
PubMed: 15042382
DOI: 10.1007/s00404-004-0608-z -
Lab Animal Feb 2007
Topics: Abdomen; Animals; Ascitic Fluid; Dilatation, Pathologic; Fatal Outcome; Female; Mice; Pancreas; Pancreatitis; Peritonitis; Rodent Diseases
PubMed: 17245383
DOI: 10.1038/laban0207-18 -
Neurogastroenterology and Motility Jul 2012Early life trauma can predispose to increased visceral pain perception. Human neuroimaging studies emphasize that altered brain processing may contribute to increased...
BACKGROUND
Early life trauma can predispose to increased visceral pain perception. Human neuroimaging studies emphasize that altered brain processing may contribute to increased visceral sensitivity. The aim of our study was to evaluate brain responses to painful visceral stimuli in maternal-separated rats before and after acute stress exposure in vivo.
METHODS
H(2)(15)O microPET scanning was performed during colorectal distention in maternal-separated rats before and after water avoidance stress. Brain images were anatomically normalized to Paxinos space and analyzed by voxel-based statistical parametric mapping (SPM2). Colorectal induced visceral pain was assessed by recording of the visceromotor response using abdominal muscle electromyography.
KEY RESULTS
Colorectal distention (1.0-2.0 mL) evoked a volume-dependent increase in visceromotor response in maternal-separated rats. Stress [water avoidance (WA)] induced an increased visceromotor response to colorectal distention in awake and anesthetized rats. In pre-WA rats, colorectal distention evoked significant increases in regional blood flow in the cerebellum and periaquaductal gray (PAG). Colorectal distention post-WA revealed activation clusters covering the PAG as well as somatosensory cortex and hippocampus. At maximal colorectal distention, the frontal cortex was significantly deactivated.
CONCLUSIONS & INFERENCES
WA stress induced increased pain perception as well as activation of the somatosensory cortex, PAG, and hippocampus in maternal-separated rats. These findings are in line with human studies and provide indirect evidence that the maternal separation model mimics the cerebral response to visceral hypersensitivity in humans.
Topics: Animals; Brain; Dilatation, Pathologic; Electromyography; Female; Hyperalgesia; Intestines; Maternal Deprivation; Positron-Emission Tomography; Rats; Rats, Long-Evans; Stress, Psychological; Visceral Pain
PubMed: 22509925
DOI: 10.1111/j.1365-2982.2012.01919.x -
Clinical Pediatrics May 1995Between January 1985 and January 1990, six cases of neonatal-onset chronic intestinal pseudo-obstruction syndrome (CIPS) were identified. Failure to gain weight in six...
Between January 1985 and January 1990, six cases of neonatal-onset chronic intestinal pseudo-obstruction syndrome (CIPS) were identified. Failure to gain weight in six cases, abdominal distention in five, and vomiting in five were the most common presenting symptoms. The contrast studies of the gastrointestinal tract demonstrated delayed transit time in 6/6, jejunal or ileal dilatation in 1/6, megaduodenum in 1/6, dilatation of the colon with barium retention in 4/6, and microcolon in 1/6. Urinary tract involvement was noted in three patients. Laparotomy, performed in three patients, revealed no mechanical obstruction. Except for hypoganglionosis in Patient 4, no recognizable neuropathy or myopathy was noted histopathologically. Four patients expired within 2 months after discharge. We conclude that CIPS with neonatal onset should be suspected when infants have urinary retention and abdominal distention or constipation beginning at birth or soon after. The prognosis of CIPS presenting in the newborn period appears worse than that presenting in childhood or adulthood.
Topics: Abdomen; Chronic Disease; Colonic Diseases; Constipation; Dilatation, Pathologic; Duodenal Diseases; Failure to Thrive; Female; Gastrointestinal Transit; Humans; Ileal Diseases; Infant; Infant, Newborn; Intestinal Pseudo-Obstruction; Jejunal Diseases; Male; Retrospective Studies; Syndrome; Urinary Retention; Vomiting
PubMed: 7628166
DOI: 10.1177/000992289503400503