Gastric distension and duodenal lipid infusion modulate intestinal gas transit and tolerance in humans.
OBJECTIVE
Patients with unexplained abdominal complaints often attribute their symptoms to intestinal gas and indicate that symptoms are exacerbated by ingestion of a meal. However, the mechanisms responsible are unknown. Our aim was to analyze the specific influence of two meal-related factors, gastric distension, and intestinal nutrients, on intestinal gas dynamics and tolerance.


METHODS
In 35 healthy subjects, gas evacuation and perception of jejunal gas infusion (12 ml/min) were measured for 3 h, during simultaneous duodenal infusion of saline, as control, lipids at 1 Kcal/min, or gastric distension.


RESULTS
Infusion of lipids into the duodenum induced gas retention (584 +/- 154 ml, p < 0.05 vs 161 +/- 86 ml after saline infusion) without perception (2.2 +/- 0.5 score), whereas gastric distension induced perception (score 5.6 +/- 0.4, p < 0.05 vs score 1.9 +/- 0.4 after saline) without gas retention (7 +/- 205 ml).


CONCLUSIONS
Different meal-related factors exert specific effects on intestinal gas dynamics and tolerance, and these mechanisms may interact to produce postprandial gas symptoms.
D015746:Abdominal Pain / Q000209:etiology* / Q000503:physiopathology*; D000293:Adolescent; D000328:Adult; D004386:Duodenum / Q000187:drug effects* / Q000503:physiopathology*; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D005414:Flatulence / Q000150:complications* / Q000503:physiopathology*; D005772:Gastrointestinal Transit / Q000187:drug effects* / Q000502:physiology*; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D019518:Postprandial Period / Q000187:drug effects / Q000502:physiology; D012016:Reference Values; D013270:Stomach / Q000187:drug effects* / Q000503:physiopathology*
D005217:Fat Emulsions, Intravenous