Assessment of abdominal bloating in patients with irritable bowel syndrome by measurement of abdominal gas volume and colonic sensory and motility function

[785636]对肠易激综合征（IBS）患者的腹胀知之甚少。我们调查了肠易激综合征患者比健康人表现出更严重的腹胀的假设，以及腹胀的严重程度与结肠内脏过敏或腹气量无关，而与主观症状有关。37名IBS患者和18名健康受试者参与了这项研究。采用经验证的IBS严重程度指数（IBSSI）、胃肠评分量表（GSRS）和IBS-QOL问卷对IBS症状严重程度和健康相关生活质量进行评分。疼痛敏感性对腔内膨胀和平滑肌张力直肠使用气压装置和腹部气体体积的百分比在腹部x线平片也进行了评估。与健康对照组相比，IBS患者在各症状的严重程度上得分均显著高于对照组，而IBS- qol得分则显著低于对照组。肠易激综合征患者对直肠膨胀的痛阈值明显降低，但直肠张力和腹部气体量在患者和对照组之间无显著差异。腹胀严重程度与便秘有显著正相关。腹胀的严重程度与直肠疼痛感、运动或腹气量没有显著关系。本研究结果表明，IBS患者腹胀本身可能影响其日常活动，症状的严重程度可能并不总是由胃肠道气体含量决定，而是由包括主观感受在内的多种因素决定。

0785636Little has been known about abdominal bloating observed in patients with irritable bowel syndrome (IBS). We investigated the hypotheses that IBS patients show more severe abdominal bloating than healthy subjects and that severity of abdominal bloating is not associated with visceral hypersensitivity in the colon or abdominal gas volume but with subjective symptoms.Thirty seven patients with IBS and 18 healthy subjects were participated in the study. Validated questionnaires of IBS severity index (IBSSI), gastrointestinal rating scale (GSRS) and IBS-QOL were used to score IBS symptom severity and health related QOL. Pain sensitivity to intraluminal distention and smooth muscle tone in the rectum using with a barostat device and percent of abdominal gas volume in an abdominal plain x-ray film were also assessed.IBS patients had significantly higher scores on the severity of each symptom and lower score on the IBS-QOL compared with healthy controls. IBS showed significantly lower pain threshold to the rectal distention but no significant difference in rectal tone or abdominal gas volume was observed between the patients and controls. There was a significant positive correlation between severity of abdominal bloating and constipation. There were no significant relationships of severity of abdominal bloating with rectal pain perception, motility or abdominal gas volume.The findings of the present study suggest that abdominal bloating in IBS patients per se may affect their daily activity and that the symptom severity may not be always determined by gas content in the gastrointestinal tract but by multiple factors including subjective feelings.