Gas-Bloat Syndrome

Gas-bloat syndrome refers to a three-faceted clinical picture: the patient feels bloated; the abdomen distends; and the individual may verbalize the discomfort as suffering from “too much gas.” Nowadays, it is more often designated and classified as functional bloating by the Rome criteria (with or without abdominal distension). The gas-bloat syndrome is produced by several interacting mechanisms including excess accumulation of intra-luminal air and/or fluid in the gut, visceral hypersensitivity, and abnormal viscera-somatic reflexes that reshape the abdominal cavity creating the appearance of distension. The diagnosis is largely clinical, but specialized imaging, breath tests, and more sophisticated motility tests may be helpful in selected cases. Treatment is tailored to symptom severity and patient concerns, ranging from simple reassurance to dietary modification and pharmacotherapy to help clear retained stool in patients with constipation, reduce gas production, decrease visceral hypersensitivity, and correct abnormal chest-diaphragm-abdominal muscle activity by biofeedback.