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

0785636肠易激综合征（IBS）患者中观察到的腹胀知之甚少。我们研究了IBS患者比健康受试者表现出更严重的腹胀，腹胀的严重程度与结肠内脏高敏感性或腹部气体量无关，但与主观症状有关的假设。采用经验证的IBS严重程度指数（IBSSI）、胃肠功能评定量表（GSRS）和IBS-QOL问卷对IBS症状严重程度和健康相关QOL进行评分。肠易激综合征患者的疼痛敏感性和直肠平滑肌张力也进行了评估。IBS患者的每种症状的严重程度评分显著高于健康对照组，IBS-QOL评分显著低于健康对照组。IBS患者对直肠扩张的痛阈显著降低，但直肠张力和腹气量与对照组无显著差异。腹胀程度与便秘程度呈显著正相关。腹胀的严重程度与直肠疼痛感、运动性或腹部气体体积无显著关系，本研究的结果表明，IBS患者本身的腹胀可能会影响他们的日常活动，症状的严重程度可能并不总是由胃肠道中的气体含量决定，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.