Document Detail

Prolonged balloon expulsion is predictive of abdominal distension in bloating.
MedLine Citation:
PMID:  20179695     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Abdominal bloating and distension are common in patients with constipation. The precise mechanism of abdominal distension remains uncertain. We hypothesized that constipated patients with bloating plus distension exhibit a greater degree of anorectal dysfunction, potentially affecting gas evacuation, than those without distension. Therefore, our aim was to evaluate anorectal function and other clinical features in patients with constipation who exhibit bloating with and without distension. METHODS: In all, 88 female patients with abdominal bloating and either non-diarrhea irritable bowel syndrome (IBS) or functional constipation were included in the study. The presence or absence of abdominal distension was assessed according to the Rome II questionnaire, and all patients underwent comprehensive clinical assessment and anorectal function studies. RESULTS: Patients were divided into two groups: abdominal bloating with distension (D; n=53) and abdominal bloating without distension (ND; n=35). D featured a prolonged balloon expulsion time (P=0.005), a higher resting anal sphincter pressure (P=0.002), and a higher maximum anal sphincter squeeze pressure (P=0.015) than ND. They also experienced more bloating (P<0.001), more abdominal pain (P=0.004), harder stools (P=0.01), and more incomplete emptying (P=0.005). In logistic regression modeling, prolonged balloon expulsion time was a significant predictor of abdominal distension (P=0.018). CONCLUSIONS: This is the first study to show that prolonged balloon expulsion time predicts abdominal distension in patients with bloating and constipation. Hence, ineffective evacuation of gas and stool associated with prolonged balloon expulsion may be an important mechanism underlying abdominal distension.
L Shim; G Prott; R D Hansen; L E Simmons; J E Kellow; Allison Malcolm
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Publication Detail:
Type:  Journal Article     Date:  2010-02-23
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  105     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-07     Completed Date:  2010-05-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  883-7     Citation Subset:  IM    
Department of Gastroenterology, Gastrointestinal Investigation Unit, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia.
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MeSH Terms
Abdomen / physiopathology*
Anal Canal / physiopathology*
Chi-Square Distribution
Constipation / physiopathology*
Flatulence / physiopathology*
Gastrointestinal Transit
Irritable Bowel Syndrome / physiopathology*
Logistic Models
Middle Aged
Predictive Value of Tests
Rectum / physiopathology*
Sensitivity and Specificity
Statistics, Nonparametric
Comment In:
Am J Gastroenterol. 2010 Apr;105(4):888-9   [PMID:  20372139 ]

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