cqvip:Background: Patients with abdominal bloating and distension exhibit impaired transit of intestinal gas which may lead to excessive gas retention and symptoms . Furthermore, we have previously shown that intestinal gas transit is normally accelerated by rectal distension. We hypothesise that in patients with functiona l bloating this modulatory mechanism fails and impairs gas transit. Methods: In 12 healthy subjects and eight patients with abdominal bloating we compared, by p aired studies, the effect of rectal versus sham distension on intestinal gas tra nsit. Gas was infused into the jejunum (12 ml/min) for three hours with simultan eous perfusion of lipids into the duodenum (Intralipid 1 kcal/min) while measuri ng evacuation of gas per rectum. Results: In healthy subjects, duodenal lipid in fusion produced gas retention (409 (68) ml) which was prevented by rectal disten sion (90 (90) ml; p<0.05 v sham distension). In contrast, rectal distension in p atients with abdominal bloating failed to reduce lipid induced gas retention (77 1 (217) ml retention during rectal distension v 730 (183) ml during sham distens ion; NS; p<0.05 v healthy controls for both). Conclusion: Failure of distension related reflexes impairs intestinal gas propulsion and clearance in patients wit h abdominal bloating.
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