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Gut. 2014 Mar;63(3):401-8. doi: 10.1136/gutjnl-2012-303013. Epub 2013 Jun 13.

Anal gas evacuation and colonic microbiota in patients with flatulence: effect of diet.

Author information

1
Digestive System Research Unit, Departament de Medicina, University Hospital Vall d'Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Universitat Autònoma de Barcelona, , Barcelona, Spain.

Abstract

OBJECTIVE:

To characterise the influence of diet on abdominal symptoms, anal gas evacuation, intestinal gas distribution and colonic microbiota in patients complaining of flatulence.

DESIGN:

Patients complaining of flatulence (n=30) and healthy subjects (n=20) were instructed to follow their usual diet for 3 days (basal phase) and to consume a high-flatulogenic diet for another 3 days (challenge phase).

RESULTS:

During basal phase, patients recorded more abdominal symptoms than healthy subjects in daily questionnaires (5.8±0.3 vs 0.4±0.2 mean discomfort/pain score, respectively; p=<0.0001) and more gas evacuations by an event marker (21.9±2.8 vs 7.4±1.0 daytime evacuations, respectively; p=0.0001), without differences in the volume of gas evacuated after a standard meal (262±22 and 265±25 mL, respectively). On flatulogenic diet, both groups recorded more abdominal symptoms (7.9±0.3 and 2.8±0.4 discomfort/pain, respectively), number of gas evacuations (44.4±5.3 and 21.7±2.9 daytime evacuations, respectively) and had more gas production (656±52 and 673±78 mL, respectively; p<0.05 vs basal diet for all). When challenged with flatulogenic diet, patients' microbiota developed instability in composition, exhibiting variations in the main phyla and reduction of microbial diversity, whereas healthy subjects' microbiota were stable. Taxa from Bacteroides fragilis or Bilophila wadsworthia correlated with number of gas evacuations or volume of gas evacuated, respectively.

CONCLUSIONS:

Patients complaining of flatulence have a poor tolerance of intestinal gas, which is associated with instability of the microbial ecosystem.

KEYWORDS:

Colonic Bacteria; Colonic Fermentation; Colonic Microflora; Functional Bowel Disorder; Visceral Sensitivity

PMID:
23766444
PMCID:
PMC3933177
DOI:
10.1136/gutjnl-2012-303013
[Indexed for MEDLINE]
Free PMC Article
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