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Review
. 2023 Jan 1;118(1):41-45.
doi: 10.14309/ajg.0000000000002044. Epub 2022 Sep 30.

Abdominophrenic Dyssynergia: A Narrative Review

John A Damianos  1 , Sanjeevani K Tomar  2 , Fernando Azpiroz  3 , Elizabeth Barba  4
Affiliations
Review

Abdominophrenic Dyssynergia: A Narrative Review

John A Damianos et al. Am J Gastroenterol. .

Abstract

Chronic bloating and abdominal distension are common and highly bothersome gastrointestinal symptoms. Although the differential diagnoses for bloating and distension are broad, these symptoms are frequently associated with disorders of the gut-brain interaction. Functional abdominal bloating may be a result of visceral hypersensitivity, whereas abdominal distension seems to be a somatic behavioral response associated with abdominophrenic dyssynergia, featuring diaphragmatic contraction and abdominal wall relaxation. We review the available literature regarding abdominophrenic dyssynergia and comment on its epidemiology, diagnosis, treatment, and avenues to address in the near future.

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Conflict of interest statement

Guarantor of the article: Fernando Azpiroz, MD, PhD.

Specific author contributions: J.D., S.T., and E.B.: study design, conduction of review, data analysis. F.A.: data interpretation.

Financial support: None to report.

Potential competing interests: None to report.

Figures

Figure 1.
Figure 1.
Schematic representation of abdominophrenic interactions. (a) In normal conditions, the abdominal walls actively adapt to its content: A volume increase elicits a coordinated relaxation of the diaphragm and contraction of the anterior wall to expand the abdominal cavity without anterior protrusion. (b) In patients, abdominal distension is produced by a paradoxical contraction of the diaphragm and anterior wall relaxation.
Figure 2.
Figure 2.
Example of abdominal distension. Three-dimensional reconstructions of CT scans obtained in the same patient during basal conditions and during an episode of abdominal distension. Note diaphragmatic descent and abnormal redistribution of abdominal content associated with distension. CT, computed tomography.
See this image and copyright information in PMC

References

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