Clinical–Alimentary TractLipid-induced intestinal gas retention in irritable bowel syndrome☆,☆☆
Section snippets
Participants
Thirty patients with IBS (26 women and 4 men; age range, 24–63 years) and 45 healthy individuals (26 women and 19 men; age range, 18–33 years) participated in the study after giving written informed consent. Healthy subjects were recruited by public advertising and completed a pre-entry questionnaire to establish the absence of gastrointestinal symptoms. Patients with abdominal bloating were selected on the basis of Rome II IBS diagnostic criteria; they had no detectable abnormalities on
Effect of duodenal lipids on gas dynamics in healthy subjects
During duodenal perfusion of saline alone (control), healthy subjects tolerated the jejunal gas infusion without gas retention, abdominal symptoms, or distention (Figures 1–3).
Discussion
We have shown both that intestinal gas transport is delayed by intraluminal lipids and that lipid-induced inhibition of gut propulsive motility is up-regulated in a subgroup of patients with IBS who report abdominal bloating. Furthermore, the differences in gas handling between patients and healthy controls seem so clear-cut that the gas challenge test may be used as a marker of disease in this type of patients.
The gut in healthy subjects is able to transport and evacuate large gas loads,
Acknowledgements
The authors thank Nuria Ferrer and Isidre Casals, Serveis Cientifico-Tecnics of the Central University of Barcelona, for help with gas infrared absorbance analysis; Maite Casaus and Anna Aparici for technical support; Gloria Santaliestra for secretarial assistance; and Cristine O'Hara for English-language editing of the manuscript.
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Address requests for reprints to: Fernando Azpiroz, M.D., Digestive System Research Unit, Hospital General Vall d'Hebron, 08035 Barcelona, Spain. e-mail: [email protected]; fax: (34) 93 489 44 56.
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Supported in part by the Spanish Ministry of Science and Technology (grant BSA 2001-2584), by the Catalonian Government (Generalitat de Catalunya, Department d'Universitats, Recerca i Societat de la Informació, RE: 2000SGR 00123), by the U.S. National Institutes of Health (DK 57064), by a scholarship from the Spanish Ministry of Education (CICYT) (to J.S.), and by a scholarship from the University of Bologna (to B.S.).