Alimentary TractIntestinal gas dynamics and tolerance in humans☆,☆☆
Section snippets
Participants
Forty-six healthy individuals (21 women and 25 men; age range, 21–29 years) participated in the study after giving written informed consent. Before entering the study, each subject completed a questionnaire to determine the absence of medication intake and gastrointestinal symptoms, particularly constipation, excessive straining at defecation, difficult anal gas evacuation, feeling of excessive abdominal gas, or excessive gas evacuation. The protocol for the study had been approved by the
General conditions
In all studies, the infusion of gas was uneventful, without any sign of leakage or inflow problems. All subjects but 5 tolerated the whole procedure. In these 5 subjects, who underwent infusion at 4 mL/min (n = 1), 12 mL/min (n = 1), and 30 mL/min (n = 3), the study had to be discontinued between 90 and 150 minutes, after the start of infusion. Nevertheless, data from these 5 subjects were included for analysis. The anal cannula proved to have been kept reliably in the appropriate position by
Discussion
We have shown that within the physiological range, intestinal gas tolerance is normally high, because gut transit and evacuation prevent gas pooling and symptoms. However, when this protective mechanism fails or is overcome, subjective symptoms, predominantly bloating, and objective abdominal distention may develop.
Little is known about the mechanical aspects of gas handling by the normal gut. Basically, the only quantitative data on intestinal gas physiology were acquired by Levitt et al. more
Acknowledgements
The authors thank Nuria Ferrer and Isidre Casals, Serveis Cientifico-tecnics of the Central University of Barcelona, for help in gas infrared absorbance analysis; Anna Aparici and Maite Casaus for technical support; and Gloria Santaliestra for secretarial assistance.
References (30)
- et al.
Volume, composition, and source of intestinal gas
Gastroenterology
(1970) - et al.
Gastric tone measured by an electronic barostat in health and postsurgical gastroparesis
Gastroenterology
(1987) - et al.
Gastric tone determines the sensitivity of the stomach to distention
Gastroenterology
(1995) - et al.
Perception and reflex responses to intestinal distention in humans are modified by simultaneous or previous stimulation
Gastroenterology
(1995) The quantity and composition of human colonic flatus
Gastroenterology
(1949)- et al.
Epidemiology of colonic symptoms and the irritable bowel syndrome
Gastroenterology
(1991) Physiological basis of gas exchange in the gut
Ann NY Acad Sci
(1968)- et al.
Influence of gaseous transfer between the colon and blood stream on percentage gas compositions of intestinal flatus in man
Am J Physiol
(1948) Volume and composition of human intestinal gas determined by means of an intestinal washout technic
N Engl J Med
(1971)- et al.
Studies of a flatulent patient
N Engl J Med
(1976)
Visible abdominal distension and gas surface: description of an automatic method of evaluation and application to patients with irritable bowel syndrome and dyspepsia
Eur J Gastroenterol Hepatol
Abdominal distension in female patients with irritable bowel syndrome: exploration of possible mechanisms
Gut
The role of intestinal gas in functional abdominal pain
N Engl J Med
Production and excretion of hydrogen gas in man
N Engl J Med
Physiologic variations in canine gastric tone measured by an electronic barostat
Am J Physiol
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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. Fax: (34) 93-428-18-83.
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Supported in part by the Spanish Ministry of Education (Dirección General de Enseñanza Superior del Ministerio de Educacion y Cultura, PM 97-0096). Dr. Serra was supported by a scholarship from the Spanish Ministry of Education (CICYT).