Bloating, Visible Abdominal Distension, and Other Intestinal Gas‐Related Symptoms in Irritable Bowel Syndrome and Functional Dyspepsia

BACKGROUND: Bloating refers to the sensation of tension in the abdomen, reported in the presence or absence of visible abdominal distension. These and other gas-related symptoms are often reported by patients with irritable bowel syndrome (IBS) and functional dyspepsia (FD). However, the prevalence of bloating and visible abdominal distension as separate symptoms in these disorders is not well known. The aim of this study was to investigate the link between bloating, distension, and intestinal gas-related symptoms with IBS and FD, and their overall impact. METHODS: Data from a population-based internet survey of adults from the US, UK, and Mexico were used. This survey included Rome IV diagnostic questions for IBS and FD, questions to distinguish between ≥ weekly bloating and/or distension, and the Intestinal Gas Questionnaire (IGQ) to assess the impact of six gas-related symptoms. RESULTS: The analyses included 131 individuals with only IBS, 360 with only FD, 217 with IBS + FD and 4740 without IBS and FD (reference group). Individuals with IBS (64.9%), FD (50.6%), and especially IBS + FD (88.5%) reported bloating and/or distension more frequently than the reference group (13.7%). Bloating and distension as distinct and combined symptoms were strongly linked to IBS and FD even after correcting for confounding factors. Also, other gas-related symptoms had a higher impact on individuals with IBS and/or FD compared with the reference group. DISCUSSION: Bloating and visible abdominal distension can occur as concomitant or distinct impactful symptoms and are, together with other gas-related symptoms, strongly linked to IBS and FD. These findings may provide arguments to include bloating and distension as supportive criteria for IBS and FD diagnoses.