Impaired intestinal gas clearance during marked hyperglycemia in patients with functional abdominal bloating.
BACKGROUND
Especially in patients with functional intestinal disorders, impaired intestinal gas transit can be involved in abdominal symptom generation. We have previously demonstrated an acceleration of intestinal gas clearance in health during acute fasting hyperglycemia and hypothesize that in patients with functional abdominal bloating this mechanism may fail.


METHODS
In 14 healthy subjects and 14 patients with functional abdominal bloating we compared effects of acute fasting hyperglycemia (approximately 12 mmol/l) and during euglycemia (control studies) on intestinal gas dynamics. Gas was infused into the jejunum (12 ml/min) for 120 min while rectal gas evacuation was continuously measured; perception and abdominal girth changes were separately evaluated.


RESULTS
Marked hyperglycemia accelerated gas evacuation (-98 (53) ml 1 h intestinal gas retention) in health. In patients with functional abdominal bloating, marked hyperglycemia failed to accelerate gas transit and intestinal gas retention developed (421 (116) ml 1 h intestinal gas retention, p < 0.05 vs. health) which results in increased abdominal symptoms (perception score >3) and abdominal distension (>3 mm girth increment) as compared with control subjects (p < 0.05 for both).


CONCLUSIONS
Intestinal gas clearance is delayed in patients with functional abdominal bloating and the increase in gas clearance during acute hyperglycemia in healthy volunteers does not occur in these patients.
Hernando-Harder
Ana Cristina
AC
Department of Medicine II (Gastroenterology, Hepatology and Infectious Diseases), University Hospital of Heidelberg at Mannheim, Mannheim, Germany.
Riddinger
Frank
F
Krammer
Heinz-Juergen
HJ
Brade
Joachim
J
Singer
Manfred Vincenz
MV
Harder
Hermann
H
D000328:Adult; D016022:Case-Control Studies; D003109:Colonic Diseases, Functional / Q000378:metabolism / Q000503:physiopathology*; D004884:Eructation / Q000503:physiopathology; D005215:Fasting; D005260:Female; D005414:Flatulence / Q000378:metabolism / Q000503:physiopathology*; D005740:Gases / Q000378:metabolism*; D005772:Gastrointestinal Transit / Q000502:physiology*; D006801:Humans; D006943:Hyperglycemia / Q000503:physiopathology*; D007422:Intestines / Q000502:physiology; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012307:Risk Factors
D005740:Gases