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Multicenter Study
. 2008 Jun;57(6):756-63.
doi: 10.1136/gut.2007.142810.

Prevalence and risk factors for abdominal bloating and visible distention: a population-based study

X Jiang  1 , G R Locke 3rd, R S Choung, A R Zinsmeister, C D Schleck, N J Talley
Affiliations
Multicenter Study

Prevalence and risk factors for abdominal bloating and visible distention: a population-based study

X Jiang et al. Gut. 2008 Jun.

Abstract

Background: Abdominal bloating and visible distention are common yet poorly understood symptoms. Epidemiological data distinguishing visible distention from bloating are not available. We aimed to evaluate the prevalence and potential risk factors for abdominal bloating and visible distention separately in a representative US population, and their association with other functional gastrointestinal disorders (FGIDs).

Methods: The validated Talley Bowel Disease Questionnaire was mailed to a cohort selected at random from the population of Olmsted County, Minnesota. The complete medical records of responders were abstracted; 2259 subjects (53% females; mean age 62 years) provided bloating and distention data.

Results: The age and sex-adjusted (US White 2000) overall prevalence per 100 for bloating was 19.0 [95% confidence interval (CI), 16.9 to 21.2] vs 8.9 (95% CI, 7.2 to 10.6) for visible distention. Significantly increased odds for bloating alone and separately for distention (vs neither) were detected in females, and in those with higher overall Somatic Symptom Checklist (SSC) scores and higher scores of each individual SSC item. Further, females [odds ratio (OR), 1.5; 95% CI, 1.0 to 2.1], higher SSC score (OR, 1.4; 95% CI, 1.1 to 1.8), constipation-predominant irritable bowel syndrome (OR, 2.3; 95% CI, 1.3 to 4.1), dyspepsia (OR, 1.9; 95% CI, 1.1 to 3.2), and gastro-intestinal symptom complex overlap (OR, 1.7; 95% CI, 1.1 to 2.7) significantly increased odds for distention over bloating alone.

Conclusions: Bloating and distention are common and have similar risk factors; somatisation probably plays a role.

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Figures

Figure 1
Figure 1
Flow chart of sampling techniques used in the study. *Note that there were 11 misclassified patients who said “yes” to the bloating with distention question but “no” to the bloating question who were added into the distention group. The exact wording of the questions assessing bloating and visible distention from the questionnaire is included in the shaded boxes.
Figure 2
Figure 2
The proportion of abdominal bloating and visible distention among FGIDs, GORD as well as in subjects with none of these disorders (no FGIDs). The lower part of each column shows the proportion with distention. The GI overlap group included all subjects with complex symptoms meeting the criteria for more than one of irritable bowel syndrome (IBS), functional constipation (FC), functional dyspepsia (FD) and gastro-oesophageal reflux disease (GORD). GI, gastrointestinal; IBS, irritable bowel syndrome; IBS-C, constipation-predominant IBS; IBS-D, diarrhoea-predominant IBS.
Figure 3
Figure 3
Potential risk factors for (A) bloating alone vs normal (B) visible distention vs normal, and (C) distention vs bloating alone among residents of Olmsted County, Minnesota. Logistic regression analysis was used to adjust for age, gender, somatic symptom checklist (SSC) score; age, gender and SSC score each adjusted for the other two factors; education refers to college graduate or professional training vs high school. BMI, body mass index; SSC, Somatic Symptom Checklist.
Figure 4
Figure 4
(A) Distribution of only IBS, only dyspepsia, only FC, only GORD and GI complex overlap subjects as well as subjects with none of these disorders (no FGIDs) in groups with bloating alone, distention and no bloating/distention (no B/D) in Olmsted County, Minnesota. (B) Distribution of any IBS subtype (IBS-D; IBS-C, IBS-M and IBS-U) in group with bloating alone, distention and no bloating/distention (B/D) in Olmsted County, Minnesota. The numbers in brackets behind the series legend are absolute case numbers of each disorder in bloating/distention/no bloating or distention groups. FC, functional constipation; FGIDs, functional gastro-intestinal disorders; GI, gastro-intestinal; GORD, gastro-oesophageal reflux disease; IBS, irritable bowel syndrome; IBS-C, constipation-predominant IBS; IBS-D, diarrhoea-predominant IBS; IBS-M, mixed IBS (meets the criteria for both IBS-C and IBS-D); IBS-U, unsubtyped IBS (not meeting the criteria for the other three categories.
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References

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