Colonic Fermentation IBS.pdf

R B M a I B t r v p g o m a b t b i i b h s d a p c e b d s v d b w C t h B b d i e s i i t r k b CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2006;4:1242–1247ole of Colonic Fermentation in the Perception of Colonic Distention in Irritable owel Syndrome and Functional Bloating ICHELE DI STEFANO, EMANUELA MICELI, ANTONIO MISSANELLI, SAMANTA MAZZOCCHI, PAOLA TANA, nd GINO ROBERTO CORAZZA Department of Medicine, IRCCS “S. Matteo” Hospital, University of Pavia, Pavia, Italy i t s a h g o g t w t o n o s d f a r o e e i i r r o w a ( 1 d y A f b dackground Aims: Bloating represents a frequent gas- rointestinal symptom, but the pathophysiologic mechanism esponsible for its onset is still largely unknown. Patients ery frequently attribute the sensation of bloating to the resence of excessive bowel gas, but not all patients with as-related symptoms exhibit increased intestinal production f gas. It is therefore possible that other still unrecognized echanisms might contribute to its pathophysiology. Our im was to evaluate whether a subgroup of patients affected y functional abdominal bloating presents hypersensitivity o colonic fermentation. Methods: Sixty patients affected y functional gastrointestinal disorders (11 functional bloat- ng, 36 constipation-predominant, and 13 diarrhea-predom- nant irritable bowel syndrome) and moderate to severe loating took part in the study. Twenty sex- and age-matched ealthy volunteers were enrolled as a control group. All the ubjects underwent a preliminary evaluation of breath hy- rogen excretion after oral lactulose. Then, on a separate day, n evaluation of sensitivity thresholds at rectal level was erformed with a barostat before and after the induction of olonic fermentation with oral lactulose. A control test with lectrolyte solution was also performed. Results: Both reath hydrogen excretion and mouth-to-cecum transit time id not differ between the 4 groups studied. Neither electrolyte olution nor lactulose modified sensitivity threshold