| Abstract: |
IBS is characterized by abdominal pain or discomfort associated with abnormal bowel habits (diarrhea, constipation, or alteration between the two) and related symptoms such as bloating, straining, feelings of incomplete evacuation, and urgency. This article explores the pathogenesis of bloating and visible abdominal distention in irritable bowel syndrome (IBS). The authors note that abdominal bloating is a relevant, troublesome, and poorly understood clinical problem. Despite its clinical importance, bloating remains substantially ignored, without proper clinical classification, known pathophysiology, and effective treatment. The authors propose a framework for investigating bloating, considering key factors potentially involved in its pathophysiology, including distorted sensation, mechanisms of physical intra- abdominal expansion, and mechanisms of abdominal wall adaptation to content and deformation. Some evidence exists to indicate that patients who complain of bloating have impaired transit and tolerance of intestinal gas loads. The authors conclude that the problem does not seem to be too much gas, however, but rather abnormal responses to gas. In addition, abnormal control of abdominal muscle activity in these patients may contribute to objective distension. 69 references. |