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The symptom of bloating means a feeling of being puffed up in the abdomen. Bloating can have many different causes and is also part of the normal spectrum of signals from the alimentary tract. Bloating can be felt, for example, after eating a little too much. A population survey in the USA reported that 16% of healthy individuals experienced bloating at least once a month.1 The origin of such ‘physiological’ bloating is likely the stomach or the upper small intestine.2 ,3 Abnormal bloating occurs in functional gastrointestinal disorders, in particular, the irritable bowel syndrome (IBS), functional dyspepsia and functional bloating. Bloating is perceived as the most frequent and bothersome symptom by patients with IBS.4 There is considerable overlap between bloating, as defined above, and abdominal distension. The latter is sometimes specified as measurable or visible distension, thus implying that abdominal distension is a clinical sign rather than a symptom.5 Abdominal distension was found in 76%–85% of IBS patients with bloating.4 ,6 A study that employed an objective method for measuring abdominal girth found abdominal distension in 48% of patients with IBS and bloating.7 Contrary to …
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