Original Contribution | Published:

Functional GI Disorders

Physical Activity and Intestinal Gas Clearance in Patients with Bloating

The American Journal of Gastroenterology volume 101, pages 25522557 (2006) | Download Citation

Subjects

Abstract

BACKGROUND:

Patients complaining of abdominal bloating have impaired tolerance and clearance of intestinal gas loads. Mild exercise enhances intestinal clearance and prevents retention of intestinal gas loads in healthy subjects. Our aim was to evaluate the putative beneficial effects of physical activity in patients with abdominal bloating.

METHODS:

In eight patients complaining of bloating, seven with irritable bowel syndrome, and one with functional bloating, according to Rome II criteria, a gas mixture was continuously infused (12 mL/min) into the jejunum for 120 min with simultaneous duodenal lipid perfusion (1 kcal/min). Gas evacuation, perception (0–6 scale), and abdominal girth were measured at 15-min intervals. Paired studies were randomly performed in the supine position during intermittent pedaling (5 min with 3-min rest intervals at 40 rpm and 0.15 kp load) versus rest (as control).

RESULTS:

During rest, a significant proportion of the gas infused was retained in the gut (45 ± 9%, P < 0.01 vs basal), but retention was significantly lower during exercise (24 ± 7%, P < 0.05 vs rest). Gas retention during rest was associated with significant abdominal symptoms (3.6 score; P < 0.01 vs basal), and symptoms also improved during exercise (2.8 score, P < 0.05 vs rest). During the test, patients developed abdominal distension, which was related to the volume of gas retained (r = 0.68, P < 0.05).

CONCLUSION:

Mild physical activity enhances intestinal gas clearance and reduces symptoms in patients complaining of abdominal bloating.

Access optionsAccess options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

References

  1. 1.

    , , , et al. Symptoms and visceral perception in patients with pain-predominant irritable bowel syndrome. Am J Gastroenterol 1999;94:1320–1326.

  2. 2.

    , , , et al. Sensation of bloating and visible abdominal distension in patients with irritable bowel syndrome. Am J Gastroenterol 2001;96:3341–3347.

  3. 3.

    , , . Impaired transit and tolerance of intestinal gas in the irritable bowel syndrome. Gut 2001;48:14–19.

  4. 4.

    , , , et al. Prokinetic effects in patients with intestinal gas retention. Gastroenterology 2002;122:1748–1755.

  5. 5.

    , , , et al. Lipid-induced intestinal gas retention in irritable bowel syndrome. Gastroenterology 2002;123:700–706.

  6. 6.

    , , , et al. Impaired reflex control of intestinal gas transit in patients with abdominal bloating. Gut 2005;54:344–348.

  7. 7.

    , , , et al. Effects of physical activity on intestinal gas transit and evacuation in healthy subjects. Am J Med 2004;116:536–539.

  8. 8.

    , , , et al. Influence of body posture on intestinal transit of gas. Gut 2003;52:971–974.

  9. 9.

    , , , et al. C. Functional bowel disorders and D. Functional abdominal pain. In: Drossman DA, Corazziari E, Talley NJ et al., eds. The functional gastrointestinal disorders. Degnon Associates: Mc Lean, VA, 2000:351–432.

  10. 10.

    . Physiological basis of gas exchange in the gut. Ann N Y Acad Sci 1968;150:4–12.

  11. 11.

    , . Influence of gaseous transfer between the colon and blood stream on percentage gas compositions of intestinal flatus in man. Am J Physiol 1948;153:475–482.

  12. 12.

    , , . Gastric distension and duodenal lipid infusion modulate intestinal gas transit and tolerance in humans. Am J Gastroenterol 2002;97:2225–2230.

  13. 13.

    . Production and excretion of hydrogen gas in man. N Engl J Med 1969;281:122–127.

  14. 14.

    , . Gastric tone measured by an electronic barostat in health and postsurgical gastroparesis. Gastroenterology 1987;92:934–943.

  15. 15.

    , . Physiological variations in canine gastric tone measured by an electronic barostat. Am J Physiol 1985;248:G229–G237.

  16. 16.

    , , . Intestinal gas dynamics and tolerance in humans. Gastroenterology 1998;115:542–550.

  17. 17.

    , , , et al. An analyzer for in-line measurement of expiratory sulfur hexafluoride concentration. Anesthesiology 1985;63:84–88.

  18. 18.

    , , . Perception and reflex responses to intestinal distention in humans are modified by simultaneous or previous stimulation. Gastroenterology 1995;109:1742–1749.

  19. 19.

    , , . Modulation of gut perception in humans by spatial summation phenomena. J Physiol 1998;506:579–587.

  20. 20.

    . Gastrointestinal perception: Pathophysiological implications. Neurogastroenterol Motil 2002;14:229–239.

  21. 21.

    . Studies of pain in normal man. In: Wall P, Melzac R, eds. Textbook of pain. Churchill Livingstone: Edinburgh, 1994:315–336.

  22. 22.

    , , . The role of intestinal gas in functional abdominal pain. N Engl J Med 1975;293:524–526.

  23. 23.

    , . Intestinal gas. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran's gastrointestinal and liver disease: Pathophysiology/diagnosis/management. W.B. Saunders Co: Philadelphia, PA, 2002:155–163.

  24. 24.

    , , , et al. Reflex control of intestinal gas dynamics and tolerance in humans. Am J Physiol 2004;286:G89–G94.

  25. 25.

    , , , et al. Effects of acute graded exercise on human colonic motility. Am J Physiol 1999;276:G1221–G1226.

  26. 26.

    , , , et al. The effects of acute exercise on colonic motility. J Gastrointest Mot 1992;4:173–177.

  27. 27.

    , . Gastrointestinal transit during mild exercise. J Appl Physiol 1987;63:978–981.

  28. 28.

    . Effect of moderate exercise on bowel habit. Gut 1991;32:941–944.

  29. 29.

    , , , et al. Intestinal gas distribution determines abdominal symptoms. Gut 2003;52:1708–1713.

  30. 30.

    , , , et al. Intestinal tone and gas motion. Neurogastroenterol Motil 2006;18:905–910.

  31. 31.

    , , , et al. Sites of symptomatic gas retention during intestinal lipid perfusion in healthy subjects. Gut 2004;53:661–665.

  32. 32.

    , , , et al. Origin of gas retention and symptoms in patients with bloating. Gastroenterology 2005;128:574–579.

  33. 33.

    , , , et al. Impaired small bowel gas propulsion in patients with bloating during intestinal lipid infusion. Am J Gastroenterol 2006;101:1853–1857.

  34. 34.

    , , . Mechanisms of intestinal gas retention in humans: Impaired propulsion versus obstructed evacuation. Am J Physiol 2001;281:G138–G143.

  35. 35.

    , , . Attention and distraction: Effects on gut perception. Gastroenterology 1997;113:415–422.

  36. 36.

    , , , et al. Impaired viscerosomatic reflexes and abdominal wall dystony associated with bloating. Gastroenterology 2006;130:1062–1068.

Download references

Acknowledgements

This study was supported in part by the Spanish Ministry of Education (Dirección General de Enseñanza Superior del Ministerio de Educación y Cultura, BFI2002-03413), Instituto de Salud Carlos III (Grants PI051250 and C03/02), and the National Institutes of Health of the United States (Grant DK 57064). Dr. Villoria is supported by a scholarship from the Ministry of Health (Ayuda para Contratos post Formación Sanitaria Especializada, ISCIII 300051). Dr. Serra is supported by a grant from the Ministry of Health (ISCIII 02/3036). The authors thank Nuria Ferrer and Isidre Casals, Serveis Cientifico-Tecnics of the Central University Barcelona, for help in gas infrared absorbance analysis, Anna Aparici and Maite Casaus for technical support, Christine O'Hara for editing of the manuscript, and Gloria Santaliestra for secretarial assistance.

Author information

Affiliations

  1. Digestive System Research Unit, University Hospital Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain

    • Albert Villoria
    • , Jordi Serra
    • , Fernando Azpiroz
    •  & Juan-R Malagelada

Authors

  1. Search for Albert Villoria in:

  2. Search for Jordi Serra in:

  3. Search for Fernando Azpiroz in:

  4. Search for Juan-R Malagelada in:

Corresponding author

Correspondence to Fernando Azpiroz.

About this article

Publication history

Received

Accepted

Published

DOI

https://doi.org/10.1111/j.1572-0241.2006.00873.x