Abstract
Postprandial objective abdominal distention is frequently associated with a subjective sensation of abdominal bloating, but the relation between both complaints is unknown. While the bloating sensation has a visceral origin, abdominal distention is a behavioral somatic response, involving contraction and descent of the diaphragm with protrusion of the anterior abdominal wall. Our aim was to determine whether abdominal distention influences digestive sensations. In 16 healthy women we investigated the effect of intentional abdominal distention on experimentally induced bloating sensation (by a meal overload). Participants were first taught to produce diaphragmatic contraction and visible abdominal distention. After a meal overload, sensations of bloating (0 to 10) and digestive well-being (−5 to + 5) were measured during 30-s. maneuvers alternating diaphragmatic contraction and diaphragmatic relaxation. Compared to diaphragmatic relaxation, diaphragmatic contraction was associated with diaphragmatic descent (by 21 + 3 mm; p < 0.001), objective abdominal distension (32 + 5 mm girth increase; p = 0.001), more intense sensation of bloating (7.3 + 0.4 vs. 8.0 + 0.4 score; p = 0.010) and lower digestive well-being (−0.9 + 0.5 vs. −1.9 + 0.5 score; p = 0.028). These results indicate that somatic postural tone underlying abdominal distention worsens the perception of visceral sensations (ClinicalTrials.gov ID: NCT04691882).
Highlights
Abdominal bloating and distention are the major and most bothersome complaints in patients with functional gut disorders, such as functional dyspepsia and irritable bowel syndrome [1]
Abdominal bloating in healthy subjects can be induced by experimental increments of gut contents, for instance by inflation of a gastric balloon [3], intestinal gas infusion [4] or a meal overload [5]
It has been consistently shown that patients complaining of abdominal distension exhibit an objective increase in girth [2]
Summary
Abdominal bloating and distention are the major and most bothersome complaints in patients with functional gut disorders, such as functional dyspepsia and irritable bowel syndrome [1]. I.e., the sensation of abdominal pressure/fullness, is a subjective sensation of visceral origin. Abdominal bloating in healthy subjects can be induced by experimental increments of gut contents, for instance by inflation of a gastric balloon [3], intestinal gas infusion [4] or a meal overload [5]. Patients with functional gut disorders complaining of bloating have increased visceral sensitivity, so that physiological volumes, well tolerated by healthy subjects, reproduce their customary symptoms [6,7]. Bloating sensation may be induced by large intraluminal loads and/or increased sensitivity of the gut. Abdominal distention is a behavioural somatic response featuring diaphragmatic contraction and descent coupled with relaxation and protrusion of the anterior abdominal wall [8,9,10]
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