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Bloating is associated with impaired response to rectal distension

Bloating is a troublesome and, until recently, mysterious complaint. Over the past few years the Barcelona group have demonstrated that although normal individuals can rapidly expel infused gas, IBS patients with bloating show impairment of this response. The present study shows that simulating feeding in normal subjects by infusing fat in the duodenum impairs gas expulsion while rectal distension has the opposite effect. However, when similar studies are performed in bloated subjects the effect of duodenal fat infusion was enhanced while rectal distension failed to accelerate gas expulsion. Thus, these patients appear to have both increased sensitivity to the effects of feeding and impaired response to the pro-kinetic effect of rectal distension. Further studies are needed to define the pharmacology of this pro-kinetic effect with the possibility of developing a new treatment for such patients.
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